Just wondering if others are seeing this trend,

I am finding some of our physicians, especaily neonatology, changing their
approach to near term infants as well as IUGR.
Until recently they seemed OK to wait out the weight gain and offer pumped
hindmilk until babies began gaining well. Now it seems they prefer Neosure
22 cal so that they will gain faster. It seems that they have little to no
tolerance for any weight loss, especially if the babies are anything under 6
lbs at birth even if they are nursing well. Jaundice is another issue, where
they believe that formula will help the baby rid the jaundice more quickly.
I do know this is true, but what if it's not that severe or even if it does
requires treatment, then treat the jaundice not the breastfeeding. Sadly the
more things that change, the more they stay the same! As I look at what I
worte, I feel like we are going back 15 years - and doing what we worked so
hard to avoid as LC's.

Patient advocacy is becoming more and more difficult somedays! If anyone has
any new up to date info to share or research that indicates a need for this
chnage of thought, please do share. I suspect it has a great deal to do with
the number of near-term infants we are seeing and common threads seen in
managing thier
care.

LuAnn Smith RN, IBCLC













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