I can't remember who asked about hospital guidelines and babies who won't
nurse.  Here's what we do in back woods Id.:  Babies are put to breast as
soon as possible 20 min. to 1 hour.  We then instruct mothers to watch for
feeding cues and to offer the breast q. 3 hrs.  If the baby is not interested
we chart what we observe ie no latch, licking only ets.  We continune this as
above for 24 hrs.  If no latch at all in this period we begin mom pumping.
 The infant can then be given by syringe, cup, or finger feeding any BM.  If
the peds feel it is necessary ABM is also used (1/2 oz/ to 1 oz.)  We also at
this point initiate a referral to the lactation consultant (me).  The nurse
can also do an accucheck q. 3 hrs if this helps to calm everyone down.  The
nurses at our hospital have seen that these little guys maintain BS fine as a
rule and will almost always begin BF to some degree in the 24 hour period.  I
think it is important to follow these moms and babies closely as with early
discharge there is potential for problems ( I wrote some hospital BF policies
addressing this I used the ones in KA's book for guidelines) If you send me
your Fax or snail mail address I'll post them to you.  We have a nurse in our
unit who is an insulin dependent diabetic and is absolutely fanatical about
low blood sugar and these guidelines have calmed her down (some)

Linda Rosetti RN, IBCLC [log in to unmask]
CLarkston, Wa.

Roberta,

Regards your question about Kangaroo care;  As an old NICU nurse I have seen
kangaroo care and it is wonderful.  It is so simple it boggles a
professional. Moms don't need to read studies, they KNOW it's the best for
their babies.  A good book you will want to get is Kangaroo Care by Susan
Ludington which you can order from Childbirth graphics  1-800-299-3366.
 Another good article is Kangaroo Care:  Skin to skin contact in the NICU by
Fritzi Drosten-Brooks in Maternal Child Nursing vol. 18 Sept/ Oct. 1993.
 This article outlines some specific guidelines and has several medical
references.  Good luck and you truely are in BF friendly heaven.

Linda Rosetti
Clarkston, WA.