In addition to quoting liberally from the AAP Policy statement as also
mentioned, it is worth examining the reasoning behind some of these old die-
hard traditions. Challenge the rationale and reintroduce logic into the
nursery.
As I recall out of my antiquity in the nursery, newborns were separated
from mom for observation for those first most dangerous hours of transition
from fetal life (assuming all moms are too tired to attend to their
newborns constantly). The babies were to be NPO (nothing by mouth) for 4
hours and then fed only STERILE water, because this was a challenge feeding
(for TEF (tracheo-esophageal fistula) primarily). If there were no problems
with this feeding, then the baby could have milk of any kind. (Amazingly,
my former hospital even 25 years ago allowed the breastfeeder to nurse
immediately, but made the formula feeder to wait the 4 hours and after
water.)
For the rare baby that has TEF, the rationale went, one didn't want glucose
or formula being aspirated into the lungs, for that would make a truly
nasty pneumonia. (Mind you, the baby who truly has TEF is so "juicy" and
struggling with secretions, the baby usually won't eat anyway and the
amount of suctioning causes someone to figure it out before feeding them. I
also recall that aspirating breastmilk, though not desirable, won't cause a
clinical pneumonia like formula will - I suppose because it is
physiologically normal (pH), is full of lysozymes and white cells and more,
and simply is reabsorbed from the lungs - don't know of any reports on
this, only anecdotal accounts.)
Odd that your nursery has "advanced" this old paradigm to using glucose
water - presumably to treat the hypoglycemia that sets in because the baby
has no access to mom's milk.
Do you have at least one pediatrician champion for breastfeeding who could
go mano-a-mano with the rest of the medical staff?
Good luck!
Katharine West, MPH, MSN, RN, CNS
Covina, CA
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