Dear Friends:
I have been following a baby, #4 in the family, who was the first to be
born prematurely, at 34 weeks to an experienced mother. The baby came home
bottle-feeding, and an ounce under birth weight. At the first visit, the baby
was double wrapped in a blanket, with a hat on, and sleeping in her car seat.
The mother was attentive, and did feed the baby well, (paying attention to
the baby pacing the feed) but resisted the notion of skin-to-skin care. The
baby was cool, with an armpit temperature of 97. The mother did agree to carry
the baby more, and co-sleep at night.
When I made the second visit, the baby was 7 ounces under birth weight,
with a rectal temp of 97. I wanted the family to take the baby to the
hospital; they became very upset. They hadn't understood the difference between a
term baby that can sustain its temperature, and a preterm baby, that can't.
Asking them to take the baby to the hospital got their attention enough to
listen. I discussed skin-to-skin care again, and said that if the baby was
admitted, he would be placed in a heated box. They could do the same thing at home,
using skin-to-skin. They agreed. I called them every day; the mother became
so scared she was taking the baby's temperature with each diaper change.
Today, 4 days after that scary visit, this baby is now 9 ounces over
birthweight, with the temperature staying in the 98-99 range. The baby is
eating ravenously. The mother's behavior has also changed; she barely noticed me
at this visit, and was totally focused on her baby, holding her close, and
rocking her, whereas before she was paying some attention to the baby, but a lot
to me and to her other children.
Such a simple and powerful tool we have to use; it can improve parenting
as well as baby's health.
I have always wondered about skin-to-skin with bottle-feeding. I wonder
if the difference between bottle-feeding and breastfeeding (as documented so
beautifully by Dr. Meier) is really the difference between skin-to-skin care
and clothed holding. I would love a study where mothers of babies in NICU
serve as their own controls; one monitored feed could be a bottle-feed one with
mother and baby clothed, and the other monitored feed be bottle-fed with
skin-to-skin. I have mentioned this to many different people, and no one has
picked up on this idea.
Maybe we could get more folks to do skin-to-skin, which might be a way
to sneak breastfeeding into some families, as some babies would probably start
latching!
warmly,
Nikki Lee RN, MS, Mother of 2, IBCLC, CCE
Maternal-Child Adjunct Faculty Union Institute and University
Film Reviews Editor, Journal of Human Lactation
Support the WHO Code and the Mother-Friendly Childbirth Initiative
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