Hi, Esther:  Congratulations on your grandson.  Best wishes to the new family! 
I, too, learned many things.  They were not with a grandchild (don't have any 
of those, yet) but with my own 2nd born daughter almost 14 years ago, a 
product of an unmedicated VBAC. She was born at 35 weeks and thankfully, 
was completely healthy. She was at least 2 hours old before she saw the 
inside of the nursery, where she remained for less than an hour - time enough 
for a bath and vital signs.
Things I learned:
1.  I WAS the lactation help!  I delivered at the hospital where I had been the 
LC for almost 10 years.  I was left completely alone, although I knew bets 
were being taken among the staff as to whether I could get my preemie (5# 
10oz. and 17 inches) to nurse.
2.  I did continuous, non-stop skin-to-skin from the time she was born until 
the time we were discharged at 24 hours PP.  I did not have sore nipples or 
engorgement, ever and this was before we knew about skin-to-skin, 
asymmetric latch, and everything else we micro-manage today.
3.  The only time I have ever watched the clock during breastfeeding and only 
because I was curious as to how long it would take my daughter to begin 
consistent good nursing.  At 18 hours she started good consistent nursing.  Up 
until then, she practiced, tucked into bed with me skin-to-skin.  My milk was in 
by about 36 hours PP.  With my 3rd baby, I spent a total of 10 hours in the 
hospital (labor, delivery, recovery, home!) and had milk at 12 hours!  I am 
convinced (don't know where we would get the study group from, tho) that if 
we all birthed our babies the way Mother Nature intended, we would all have 
milk within the 1st 24 hours.  I believe that is probably the norm, not 3-5 days.
4.  Nursing can continue uninterrupted while managing jaundice.  At 72 hours 
of age (we had been home about 48 hours) my pediatrician called and told me 
my baby's bili had come back at 23. Back then, a nurse came to the house to 
do bili checks, rather than the parents having to take the baby to either the 
doctor's office or the hospital lab.  He wanted to readmit the baby for 
phototherapy, have me stop nursing for 48 hours, and feed formula.  I said NO 
to all three, but did agree to do a bili blanket at home.
My preemie baby nursed, pooped, peed, and grew into the healthy super honor 
roll middle school student she is today!  My 1st baby nursed, pooped, peed, 
and grew her way to a doctorate in OT.  My 3rd nursed, pooped, peed, and 
also grew into a healthy super honor roll middle school student!

Pam Hirsch, BSN,RN,IBCLC
Clinical Lead, Lactation Services
Advocate Good Shepherd Hospital
Barrington, IL   USA

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