Mary Kay, I hear similar questions and complaints where I work and look
forward to some of the responses from LACTNET.
I think you are on track and need to emphasize to staff that each baby needs
to evaluated and not throw all babies into a couple categories.  It should be
a "case by case" basis for a decision.
You might find some help for references if you look at Peter Hartman's work
or Nils Berman (?sp).  In Nils Berman's work he stated the average intake for
the newborn on day 1 (7-15mls), 2 (10-35mls), 3 (80-150mls).  These are
ballpark estimates since I don't have the reference here at home.
What I have not found is how much formula would be equivalent to what
colostrum can do for the newborn.  I hear at work that for a baby who has low blood
sugars that they need at least 15 mls per feeding in the first 24 hours of
life.  No one has shown me any reference to this but I am curious to what others
have heard or know.
I tell mothers and staff in the first 24 hours the baby can do with just
drops of colostrum.  If a baby is stable but just not interested in rooting and
suckling, then I show the moms how to hand express drops of colostrum onto the
baby's lips and count this as a feeding.
Interested in what others think and know.
Ann Perry, RN IBCLC
Boston, MA

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