What I would recommend in this situation is bedding in with baby, skin to
skin. I would have mom hand express every 1-3 hrs and mix any colostrum with
some D10W sugar water and feed to baby with spoon or a little dropper. I
feel being proactive is best, i.e. expressing and feeding, rather than being
reactive, i.e. waiting for signs that supplementation is needed. After about
24 hrs if not latching I would recommend a pump be used and may need to add
milk (even artificial if ebm is not alot) if jaundice or large wt loss. In
our hospital interventions are frequent if baby not urinating or has not
stooled or is becoming juandiced. If a big baby I would go 24-48 hrs on
this, but if very small, would start sooner. I try to delay interventions as
much as possible. It's not an exact science though.

Laurie Wheeler, RN, MN, IBCLC
Violet Louisiana, s.e. USA

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