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Subject:
From:
"Johnson, Martha (Lactation-SHMC)" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 13 May 2004 08:35:43 -0700
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Hello Lactnet People,
I work at a mid size Level III hospital in the northwest. Our current policy around supplementation is that the healthy term baby who is rooming in with mom has the 1st 24 hours to establish breastfeeding, and while we DO keep trying to get them to breast, we do NOT start any supplementation until they have had 24 hours of ineffective feeding.  We do check their blood sugar anytime they've gone 8 hours without latching, and would supplement for a BG less than 37.  1st choice for supplement is mother's pumped colostrum of course.  My dear co-worker would like to extend the 24 hours to 36 or even 48.  I have looked in ILCA's evidence based standards for a guideline on this to no avail.  It seems like most of the literature on hypoglycemia says the healthy term newborn has stores that last through the 1st 24 hrs.  Here's what I'd like to hear from LActnet:

1.What kind of timeline do other hospitals use for initiating supplementation in a breastfeeding dyad where breastfeeding is not going well yet?
2. Does anyone have citations from the literature that would support waiting longer than 24 hours to supplement a baby who is not feeding effectively at breast?
3.  Can Nancy Wight weigh in on this if she is available?


Please cc your posts to me personally.
Thanks in advance from 
Martha Johnson RN IBCLC
Eugene OR 
USA 
  
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