Every baby needs to be looked as an individual.  I personally remember
when there was a rule in most maternity departments that babies were
not to be fed for the first 24 hours.  This was not particularly a
good idea, but the babies were fine (from a physical point of view,
one hesitates to think of the effect of crying for most of 24 hours
and not getting their needs met).

A 24 hour discharge policy changes things.  It puts pressure on
everyone.  It is difficult to say to a mother, "We know your baby has
not fed in his entire life, but goodbye, have a good life".

Personally, unless there were a reason for concern, I would not do
anything for 12 hours (when there is a 24 hour discharge policy).
Then, if the baby still is not waking up, I would get the mother to
express some milk and finger feed it to the baby.  Finger feeding is a
good way of waking up a sleepy baby.  If the baby does not wake up, at
least he will have fed.  Expressed milk in sugar water would be a
second choice, sugar water a third. Formula is *not* necessary under
the above circumstances.  Why 12 hours?  It gives some time to get the
baby waking, get the baby to the breast, and if that does not happen,
the mother has started expressing, and can at least can feed the baby
(finger feeding), and then be followed up in the next day or two.

Jack Newman, MD, FRCPC