Dear Terri,
I have found the information from LLLI to be quite exhaustive and helpful for sleepy babies. Hope this helps.
http://www.llli.org/llleaderweb/LV/LVOctNov99p99.html
http://www.llli.org/NB/NBJulAug01p136.html
I found this particularly releveant in this case.
"Some of the actions that can contribute to oral aversion include suctioning of the newborn's airway or stomach, naso- or orogastric feeding tubes, inappropriate use of artificial nipples and bottle-feeding methods, incorrect placement of fingers in the baby's mouth for finger feeding or suck assessment, and aggressive attempts to alter the baby's sucking pattern. Some of these interventions can be helpful as long as they are done gently and slowly, paying attention to the baby's cues.
Airway suctioning is considered necessary by some health care providers. In some communities, gastric suctioning is commonly done "to promote hunger, as the baby will not eat unless he is hungry, and he won't be hungry unless his stomach is empty." This practice is based on the belief that mucus present in the baby's stomach will suppress hunger pangs, preventing effective breastfeeding. Interventions may become standard practice when health care providers believe that they will prevent problems and that they are harmless. Unfortunately, these interventions are neither harmless nor effective in prevention problems."
Take Care
Yasmin
LLLL, India
________________________________
From: Terri Klein <[log in to unmask]>
To: [log in to unmask]
Sent: Mon, 4 January, 2010 18:45:12
Subject: Fwd: sleepy baby
>>> Terri Klein 12/31/2009 8:25 am >>>
Dear Lactnet members,
I tried posting a message a few days ago but didn't see that it came through, so am trying again. We do a lot of epidurals here and more often than not they are continuous throughout the labor unless she is not pushing effectively or does not have the feeling to push. I get these sleepy baby that has no interest at all in feeding. Often times they are gaggy, the staff has delee suction a good amount of fluid before I even get a chance to see the couplet. By this message you can see I work in a hospital setting.
Skin to skin is my priority, I usually have mom try to manually express drops into a spoon so that she can offer drops every hour until this baby starts to show signs of hunger.
Often times when I revisit baby is being held by visitors no longer skin to skin. Still sleepy and because there has been many visitors she has forgotten to give any more drops. I can't always visit every hour.
This means that this baby might have fed within the first hour of birth but not again for 8-12 hrs. Where is the limit of time to let these babies go before having to offer supplements. Usually within the 12 hours they are starting to feed and may have 5-8 feedings before discharge of 24 hrs with 2-3 voids and stools.
I just don't want to be slacking on this. Our C/S moms have baby skin to skin in about an hour when they return from recovery. We hold the bath until the first or second good feeding. I try to let baby do the lead with feeding and just guide in positioning. I auscultate swallows during a feeding and try to observe 2 or more full feedings before they are discharged.
Your help will be greatly appreciated. I believe I probably asked this before but my mind is getting too ful and can't pull this one out of my head.
Thanks, please feel free to email me privately as well.
Warmly,
Terri Klein RN, IBCLC, RLC
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