Hi Janice, this is a question we have pondered many times before. <<My
question is how long is too long if baby does not nurse right away.>>
The simple answer in your situation is to have mother begin hand expressing
colostrum and spoon feeding to infant at frequent intervals (every 2 hrs for
example) if a well baby does not begin feeding in a few hours (4 hrs?).
I have said many times before, it is a judgement call, based on baby's
condition, gestation, mom/baby risk factors, staff, parents, doctor, and LC
comfort level and ability to monitor, etc.
I wish we could do a study of babies who *feed well at birth* then sleep for
long periods of time (12 hrs?) with mother, STS, vs those who *do not feed*
and sleep with mom, STS. Measure the weight loss and gain patterns, voiding
and stooling patterns, mother's milk surge timing, etc. Is this even
ethical? Are babies who don't breastfeed babies that *can't* bf, and
therefore need help? We could compare the aforementioned groups also to
babies who bf well at birth and then show no interest, but who are spoonfed
colostrum at regular, frequent intervals, also a group who did not feed at
birth but were started at 2, 4, 6, etc hours on spoonfeeding.
I am certain you know this, and it is maddening at times, but no one can
*make* a baby bf. Moms and LCs often try very hard though. Since we cannot
make the baby bf, and based on my knowledge and experience, at this point in
time, I advocate early expressing and feeding and STS and early followup for
the situations you question.
laurie
Laurie Wheeler RN MN IBCLC
Mississippi USA
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