I am a RNC in a NICU and I hear all the excuses about why the premie can not
go to breast and/or the breastmilk can not be used.  Here are some of the ones
I hear most.  Baby can't go to breast because...it tires baby out, we won't
know the exact amount of milk the baby gets, baby is too small,  burns too
many calories for baby to nurse from breast, Mom doesn't have enough milk, Mom
has too much milk.
Excuses to not use the breastmilk....Mom is taking pain meds, or some other
drug that is perfectly safe for nursing mothers, breastmilk doesn't have
enough calories for small premie, baby has GI problem and can not tolerate
breastmilk...needs Nutramigen or some other special formula, breastmilk has
been cultured and waiting for culture results.  Mother has a fever....Baby can
not go to breast until it has learned to feed from the bottle....argh!!!!
        These are only a small percentage of excuses I here on a daily basis.  I work
very hard educate our staff and improve our breastfeeding support for our
Mothers.  I think the NICU staff always need to know references where they can
find answers about breastfeeding  (books, articles, Dr. Hale's book about
medications).  If they can find the answers they are much more likely to give
the Mother correct advice.  Hope this is helpful.  Good luck with the
inservice!
Debby Menders RNC
Very cold .....WV