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Subject:
From:
PHYLLIS M KOMBOL <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 7 Jan 1996 03:46:06 EST
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If you can stand more on this subject....
I'm catching up on reading and just
couldn't resist a comment.
About 15 yrs. ago, when I first
started working with newborns, the
newbornnursery routine was NPO
(Nothing By Mouth) for 24 hours for
all babies...a few years later, very
progressive peds started feedings at
12 hours of age.  Most all those babies
actually did ok (glucose/hydration, etc.)
with this even though some were
obviously very hungry by the first feed.  The other
things we did (routine supplements with
glucose water, etc.) were often very
detrimental to breastfeeding, and while
I certainly don't ADVOCATE that kind
of delay in feeding, it is a part of my
perspective when I'm trying to coax a
<24 hour old infant to nurse and baby just
doesn't seem interested.  So I tend to
lay low and place baby skin to skin with
mom (or dad) and keep offering frequently.
Most babies come around between 18-24
hours of age.  I see alot of these sleepy babies
because the epidural rate in the hospital I
see inpatients is well over 90% (no doulas!).

On the output issue,I don't think we have
ANY  research on this...we all are using
numbers that seem to make sense to us,
but desperately need the research.  I use
1 wet & 1 BM in first 24 hours, then
2-3 each wets & BMs per day until about
24 hours after milk transition (expected by 5th
day).  We send parents home with a screening tool
that includes when milk should change/breasts
get full, and what output to expect after that time
(4 or more yellow BMs and 6 or more wets per day).
I often write in the margin what to expect before
then.  The screening tool also has process
indicators...how often, how long, swallowing,
no excessive swelling/soreness AND a big list
of community supports....adapted from Neifert's
work.

One pattern we seem to see is a pea soup or
runny green BM right before the transition to
mustardy BM's....cluster of feedings during the
last 6-10 hours before milk transition, and
also gassiness in babe just as milk is changing.
Anyone else recognize this pattern..or are we just
seeing it because we think we will?

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