Rachel Myr wrote:

>Jumping in here again to speak up in defense of normalcy - we weigh babies
>at birth and then again on day 3, meaning they should be at least 48 hours
>old when weighed a second time, but some babies may be nearly 72 hours old,
>depending on the time of day they were born.
>
>It is not at all uncommon to see babies lose about 10 per cent of their
>birthweights by the second weighing.  We look at how the baby seems:  Alert?
>Cueing to feed?  Latching well?  Hearing swallows?  Still passing meconium,
>or no stools?  Content at breast? And so on...
>
>The weight loss is expected, which is good considering it is usual in a
>hospital where we still use meperidine (pethidine) in labor, and epidurals,
>and babies take some time to get their bearings and start working to build
>mother's supply.  We only supplement if there are other clinical indications
>to do so in addition to the weight loss, and only the very nervous among us
>start supplementing when weight loss approaches 10 percent of birthweight.
>The more optimistic staff, among which I count myself, don't start even
>thinking about supplements until weight loss is closer to 15 per cent -
>again, in the absence of other clinical signs.
>
>What is the staff afraid is going to happen if mother and baby are left in
>peace for another 12 hours?  The baby is not likely to starve to death, go
>into a hypoglycemic coma or have a seizure.  The usual scenario is that
>mother, in the course of the next day or so, notes her breasts filling with
>a vengeance, accompanied by a 24 hour feeding frenzy in the baby, and then
>it's all history and they breastfeed happily ever after.  We don't usually
>need supplements, if the staff can keep their own anxiety from infecting the
>mother.
>Rachel Myr
>Kristiansand, Norway
>
>  
>
Although I am hearing paediatricians stipulate that the baby is unable 
to go home because a usually small (<2.5 kg) baby has lost 10% of their 
birth weight.  I notice this usually puts more pressure on the mother, 
she dislikes being in hospital and feels that she is *failing* as a mother.
I also heard the paed the other day insist a mother b/f her small baby, 
then express and if she couldn't express more than 20ml (on day 2) then 
she wasn't to go home and he wanted the baby comped.  What would be his 
reasoning for this?
As a counsellor I tell women that they are usually unable to express 
after feeding, they need to wait a while for the breasts to *make more 
milk*. 
Also, day 2, how many mothers could express 20 ml easily?
I am learning more about policies etc, since beginning my midwifery 
training.......


-- 
Merewyn Janson
RN/(student midwife)
Australian Breastfeeding Association counsellor ('98)
Redbank Plains, Queensland, Australia

"Women should not feel guilty if they are unable to breastfeed, but they *should* feel guilty if they are unwilling to do so, and they should be intellectually honest enough to know the difference." -Elizabeth Gene

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