Hi All,
In response to how much intervention one should use to get the sleepy
baby to the breast in the first hour of life--after the skin to skin
time.  If I have a sleepy baby challange I try to wiggle in amongst the
family and visitors and make a few suggestions.  I ask Mom is she feels
comfortable expressing a few drops of colostrum for an enticement , and
if she is willing, I give a few basic pointers and she on her own brings
up that "lovely first drop".  She usually is surprised with her efforts
and very pleased if there is a response on the baby's part.  So right
there she has learned that she does indeed have colostrum, that she can
call it up whenever she needs to, and that she can provide nourishment
for her newly-born..  I tell her a feeding licked counts, all about how
the baby is learning to extend his/her tongue, which is very helpful to
learning to latch, how we will encourage as much skin to skin in the
next hour or two as we possibly can,and I will follow up in an hour or
two and all will be well, and most of the time it is.  I think there is
an important place for Hands Off, but maybe not at the first attempt at
feeding, and that this is a call one makes after looking at as much of
the big picture as possible.  Since we in the hospital have 24 hours or
so to be of service to this family, I think it is important with the
reluctant nurser to remember we will have several attempts to assist,
and look at it as a process, much like teaching a child to ride a bike,
first running along holding on, in addition to the training wheels, then
without the training wheels, then standing and watching as they take off
on their own.
What a Great Job!
Becky Garcia, RNC,IBCLC

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