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Subject:
From:
Ann Perry <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 24 Dec 2005 18:57:26 EST
Content-Type:
text/plain
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text/plain (43 lines)
June asked:
   >  I looked after a woman to-day who baby born at  36.3 days,  now 3 days  
=
not going to the breast and requiring ebm  top-ups working  from the =
guidelines. I  worked out that the baby  needed 42 mls per top-up. =
consider the capacity of the baby stomach. I am  concerned that I dont =
have the correct information to give mothers and the  staff. <

I am assuming the 42 mls was determined by the weight of the baby and not  
being a 36.3 weeks or size of baby's stomach.
June's comments has brought up something that I am seeing at the hospital I  
work and especially with the neonatalogist.  They want to determine what a  
baby needs by cal/kg.  My argument with them is that this cannot be  factored in 
until the baby is at least 3 days old.  In the first 2 days of  life (and 
sometimes more for some babies) newborns' digestive systems are just  not capable 
of handling large amounts of food.  Once they have recovered  from delivery 
than larger amounts adjusted to cal/kg can be factored in.  
I liken the newborns digestive system to women in labor or people who just  
came out of surgery.  
I base this on all the studies and the observations of newborns.  We  all 
know that the average intake of the newborn in the first 24 hours is 7-10  
cc/feeding.  In the second 24 hours the average intake goes up but still  7-15 
cc/feeding.  Also, the composition of colostrum is high protein with  lower fat and 
sugar than mature milk.  
My argument to the neo is that a newborn in trouble does not need larger po  
intakes because they just can't handle it so will need an IV.
What do others think?  I would especially like to hear from some of  the 
pediatricians in our group.
Ann Perry, RN IBCLC
Boston, MA

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