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Subject:
From:
Lori Peters <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 18 Jul 2001 18:26:15 -0400
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>Subject: Re: latch help needed...update and thanks!...questions about
supplement use

In our area (South-East Wisconsin), the MD will re-admit a baby to the
hospital if the weight loss persists and begin IV therapy and give formula
feeds.  There was no evidence that the baby was improving and since a baby
wont stop loosing weight until she gets something in her stomach,
supplementing was the only option.  I must practice within the confines of
local practice.... more or less ;)    Not to mention the fact that I was
truly worried about this baby.

Had the baby actually been nursing and it was just a matter of the milk
needing to come in, I would agree with you.  However, 2 days without
anything stretches my level of comfort especially if the baby is showing no
signs of being able to nurse.  There were already some signs of
dehydration,  such as scanty voids and slightly depressed fontanels, which
would be expected after 2 days of not nursing, and I am not in favor of
waiting until there is a huge problem to fix before supplements are begun.

It is most interesting to get lots of different opinions on this issue..I
guess it all boils down to what we feel comfortable with, what is local
practice, what the MD's are willing to accept (I must be concerned about
this issue as I practice in a hospital),  and most certainly what we feel
is best for that individual baby.

Unfortunantly there are no good studies that I am aware of that support
letting a baby go without nutrition for a specific number of days and still
expect to have a well baby at the end.  I believe that feeding should be a
normal thing for a baby to do and if the baby is not feeding within the
first day or so..he has already told us "something about me is different"
and this becomes an issue...by letting the baby continue to go without
feeding seems to ignore the message he is already telling us and perhaps
compounding the problem with other issues.  It seems that alot of the
hospital based LCs (which I am) struggle with this issue, and I frequently
see posted questions about how long is too long to wait...also seems that
there is never a consensus of opinion, other that looking at the individual
situation.

Warmly,

Lori Peters RN/IBCLC  (International Board Certified Lactation Consultant)

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