Barbara Stokes wrote:  "could you please tell me what you base amounts on
feeding prem babies while "fattening Up" phase?  I work on
180mls/kgm/divided by 8 for 3rd hourly feeds.  If baby demanding increase, I
would offer approximately 10 to 20 mls extra.  In our small rural hospital
have twins trying to get to over 2000gms.  some midwives are offering 1820gm
baby amounts up to 75mls per 3 to 4th hourly feeds.  Could some NICU/Special
Care Nursery personell please advise with literature?"

 

Barbara - I am not an RN or MD, so I gather info about premies from those
who work in NICUs as well as from literature, conferences, etc.  To my
layman's mind, it is hard to understand why it is good to feed 2-3 ounces of
milk at one time to a tiny premie whose stomach is not large enough to hold
that quantity comfortably and to feed every 3-4 hours.  At home, the moms
continue the 3-4 hour schedule with breastfeeding but the baby is gassy and
fussy, and sometimes not gaining adequately.  During a home consult, the
moms often tell me that the premie has been diagnosed with GERD (without any
tests) and has been put on medication for that.  At that point, I suggest
breastfeeding more frequently (for example, every 1 - 2 hours).  Voila, the
GERD disappears -- the premie is no longer gassy, sleeps much better, and
grows well.  The MD then takes the premie off the medication.

Could feeding smaller amounts more frequently work in the NICU?  Could
premies go to the breast rather than be put on bottles?  Isn't that
physiologically better for the premie?  Is the extra handling a problem or
do premies do better with more touching?  In the literature, I have read
that premies absorb nutrients better if they are touched more.  I'm looking
to learn more from LACTNETTERS with more experience in NICUs.

Warm regards,

Lee Galasso, MS, LLLL, IBCLC, RLC

Westchester County in NYS, USA

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"Children Are Born with the Right to Breastfeed"

 


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