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Subject:
From:
"Deborah L. Tobin, RN, BSN. IBCLC" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 14 Oct 1997 16:38:31 -0400
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To determine if/when newborn needs supplement -
Assessment of baby status: some suggestions of parameters:
1. hydration: urine output - could check Sp Gravity on any urine you do get,
look at physical assessment such as oral mucosa.
2. stooling: initial mec-transitional
3. weight: trend (excessive initial loss?), and ac/pc
4. vital signs: ie - temp increase goes along with dehydration
5. blood sugar

Yes? Make sense? Other parameters?
Combine baby assessment with assessment at breast: position, latch, suck. And
sensations noticed by mom during feeding: sleepy, thirsty, uterine cramping
(in early days).

Wouldn't the number of hours until unfavorable S&S, in the baby, occur, and
become a concern, depends on various factors, such as: baby's size,
gestational age, length and course of labor, and .....other factors? May be
difficult to nail down an number of hours to use as a hard and fast rule. So
many variables. Items 1-4 above are among the standard ongoing assessments of
a newborn, but, if the nurse/mom reports very little or no latching during
the first 12(?) hours, .....(hate to stick a baby but).....maybe a blood
sugar would help you make a decision on need to supplement? Anyway, at 12
hours I would be looking at the situation more closely,  because I want a few
to several good sessions at breast/or adequate intake by baby and acceptable
status of above parameters ,  before that mom and baby go home.

Deb

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