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Lactation Information and Discussion <[log in to unmask]>
Date:
Mon, 14 Aug 2000 15:23:43 +0200
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I am stuck home with a very virulent contagious eye infection, because
of which I cannot go near babies or any other humans for that matter and
now that I have tons of time to read  Lactnets, there are almost
none.....where is everyone?

First of all, I am ready to move to the hospital in Atlanta that has 24
hour lactation coverage. My hospital, 9500 births/yr has only moi and
Carla's situation is more like the one I am in.  As long as I am there,
I manage to help as many moms as I can and the minute I am not, AIM
reigns, and the next morning, I am faced with breastfeeding rehab and
lots of frustration.  Babies who are doing the "bottle-mouth pucker" and
moms who are telling me that all their lives they have wanted to
breastfeed and that they came all the way from the north of the country
to deliver in this hospital because they heard about me.  But she
delivered on  Friday and I go to the beach on Saturday, so by Sunday
morning when I return, of course she has been convinced that she has no
milk, nipples that are incompatible for breastfeeding, breasts that are
too small, a baby who is too "tired/weak" to breastfeed, and that it is
not the end of the world if her baby gets Simiyuck  until the LC comes
on Sunday.  The AIM reps roam the dept giving lovely gifts to all the
staff and warning them that if an infant dehydrates, their job could be
on the line.......need I continue?  You've all seen this movie!!

Now the point of this letter: I have a big problem with babies who sleep
and don't eat the first 24 hours.  By day 3, the day that they are due
to go home, they are doing one of two things....either losing too much
weight which results in a panic on the part of the docs, nurses and not
to mention the parents, and may even result in the mom being sent home
and the baby staying one more day ( I encourage the moms to camp out on
mattresses on the floor of my breastfeeding room.) This usually totally
undermines the mom's confidence because someone has succeeded in
convincing her that her baby is in grave danger because he has lost so
much weight ( we are usually talking about an 8-10% wt loss).
The other problem is that if the baby sleeps all of day 1, what does he
do all day on day 2?   He makes up for lost time, which is great if I
get to the mom first and explain what he is doing , but this
unfortunately always happens in the middle of the night and the night
demons tell her that of course she has no milk.  Now isn't it
interesting how these babies who are marathoning on day 2 all do the
same thing?  They have this great feeding frenzy for 3 or 4 hours
straight and then if someone pops a bottle in their mouths, they take
about 5 cc's and go to sleep for a few hours.  The mom is then really
sure she has no milk unless I am there to explain that the baby took one
taste of that disgusting stuff and decided that rather than continue to
feed he would rather escape into the safety of sleep for a few hours
than risk getting another taste of that!!  Or I tell them that what they
don't realize is that after the mom went to sleep, the baby regurgitated
every drop of the offending liquid!!

These two scenarios prompt me to encourage moms to wake babies with
spoon-feeding a few drops of colostrum.....I call that " marketting" and
it always works.  After about the third spoon they are ready and willing
to feed.

By the  way, staff were given several in-services, and immediately after
there was an improvement, but the AIM lady became much more aggressive
and things went back to what they were prior to that.  I am workng on
getting non-AIM funding for a full course for the staff, however, the
AIM lady is stronger and has more money than I do and I am afraid that
in the end they will let her run the course instead of me.

Esther Grunis, IBCLC
Lis Maternity Hospital
Tel Aviv, Israel
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