Jeni,
There are many ways to tell if the baby is doing well in the first hospital days, and there are ways to tell after a baby goes home. All of which I know you are familiar with. Reassurring the hospital staff is the more difficult situation.

In hospital, and for term, well babies, staff should be looking for continuous (as much as possible) mother-infant contact (skin to skin is ideal); unrestricted access to the breast; not using pacifier (rampant use here). Secure attachment to the breast (latch); signs of milk transfer and milk ejection; signs of hydration/dehydration; weight loss (taking into account fluid loss, day of discharge, etc).

A term, well baby that is being offered the breast often and (in my opinion) being fed small puddles of colostrum on a spoon if not latching after maybe 6 to 8 hrs not feeding or sooner, does not require any supplementation. Most babies will suck the breast at least 5 min or so (in my experience) if latched well. In my experience, feeds are often 10 to 40 minutes long, but could be longer or shorter at a particular feed. Very very short feeds at every feed (1 or 2 minutes) in my experience have indicated nipple sucking or no latch. Very long feeds at every feed (for example, baby never ever seems to setle but sucks breast almost constantly and sucks hands whenever detached) would indicate poor milk transfer, insufficient milk. Feeds that always take an hour, same thing. "Others mileage may vary" as they say, this is my 34 yrs experience.

The reasons I recommend spoon feeding: many mothers will give a bottle if baby won't latch, excess wt loss and jaundice can be prevented, mom's milk supply not compromised by delayed feeding. Preterm or sick/previously sick infants need closer supervision and sometimes other alternate feeding methods.

Parents should be taught that sleepy/drowsy babies should become more interested and active with feeding after 1st day or 36 hrs or so, and will increase the wetness, heaviness, lighter color of pee once home, and increase number of poops and change color to yellowish. Wt checks are important, as some babies at home occasionally pee/poop but stall in wt.

These above things will have to be gently and repeatedly discussed and shown to staff and over time, most of us have been successful in getting staff to be more relaxed, with well babies at least.

Laurie Wheeler RN MN IBCLC
BMH-UC Breastfeeding Resource Center
 "Opinions expressed above are not necessarily those of BMH-Union County or Baptist Memorial Healthcare Corporation."


Baptist 100. Well beyond a century.

This message and any files transmitted with it may contain legally privileged, confidential, or proprietary information. If you are not the intended recipient of this message, you are not permitted to use, copy, or forward it, in whole or in part without the express consent of the sender. Please notify the sender of the error by reply email, disregard the foregoing messages, and delete it immediately.

P Please consider the environment before printing this email...


             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome