I agree, Magda, that we don't know what difference there is between babies
whose systems are unsullied by anything but own mother's milk, preferably
taken at the breast, and babies who have had drops or ounces of other
liquids given, even ritually and on a one time basis.  I would be surprised
if there were no difference, at least measurable in the short term, up to a
month or so after the fact, and possibly longer.  I would be surprised, too,
if the effects of milk from another species had less effect than do either
wine or sugar water, or if the effect were not dose related.  And what of
all the babies given antibiotics orally?  None of the preparations on the
market here are available without artificial color, flavor and sweetening
agents, not to mention the drug effects per se.  And then there are the
substances such as nitrosamines that leach out of latex or other materials
used to make artificial nipples, which also have effects.

But by the WHO definition, some of these babies would be exclusively BF
again about 25 hours later.  I don't think the WHO definition is terribly
useful for epidemiologic purposes, when BF lasts a long time, and the
exclusiveness may last only a tiny fraction of that time.

I would hate to think a mother might throw in the towel the first time
another substance crossed the baby's lips, on the grounds that the period of
exclusive BF was over, anyway, because the baby had already been given 2 ml
of glucose solution.

Re: paracetamol, in our unit it is only given to babies with injury causing
obvious discomfort, and the circumcised boys are not offered it, don't know
why!  Bruises from vacuum extractors or forceps very occasionally, or
post-operatively after orthopedic surgery, perhaps, but not after injections
or blood tests.  Parents are advised to have it on hand in case of fever in
the infant, to save themselves the trouble of having to acquire it in a
hurry.  They are also told that low grade fevers don't need immediate
treatment as long as baby is feeding well.

This has been interesting so far.  I had no idea what the WHO definition
was, and I have for years been ticking the box for 'mixed' feeding on our
discharge form if the baby has received anything but mother's milk in the
ward.  I specify amount and duration on the form to distinguish between
those who are receiving both at discharge and those who may have had a
single feed of brand X for whatever reason during their stay.  I don't
usually agree with the reason but despite my best efforts at tyrannical
dictatorship, not everyone asks my permission before feeding a baby.

back to the grindstone now, but this is so much more fun
Rachel procrastinating in Kristiansand

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