In a message dated 11/19/0 8:55:30 AM, Kristen writes:

<< My problem is when I get a sleepy baby resulting from
a medicated labour ......who has had skin to skin for half an hour or more,
and still shows no signs of attaching - when do you intervene? >>

in the area where I work, for many metro area health care facilities (one
where I work has ~3,500 births/yr, the other 10,000+ births/year) the
epidural rate may be ~90%, cs rate may be ~28%........  = many sleepy, pokey
newborns.

I am as hands on as needed to make as much BF progress as possible in the
time available. This may include discussion of and /or assistance with: light
sleep states, skin to skin holding, early cues, wake up techniques,
pre-feeding breast massage & nipple stim, position and latch, breast
compression, significant other support for the BF mom.

So, if needed I may guide the mom's hands with my hands, progressively less
as she learns.

Debbie Tobin
RN BSN IBCLC LCCE
Springfield, Virginia USA
In the suburbs outside the Washington DC beltway
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