In a message dated 11/24/2003 3:46:11 PM EST, [log in to unmask]
writes:
<< I recently had a generally very breastfeeding-supportive colleage make a
comment: If this baby had been formula fed, he would not have brain damage.
He
was correct as the exclusively breastfed baby was readmitted with a bili of
40
at 6 days of age. >>
Well, yes and no. If the baby had been feeding well, by whatever method,
breast or bottle, then it wouldn't have happened. ( or there is some underlying
problem contributing as well.) The problem is that babies who are not feeding
well are being sent home, and mom keeps putting baby to breast, but baby doesn't
feed, either at all, or well. I saw two babies this week, within days, where
for various reasons, babies were not latching. One baby didn't latch, but mom
had plently of milk, but the baby didn't get any. The other baby would latch,
but didn't eat, since at day 5 the mom seemed to have no mature milk coming in
yet, baby fought flat nipple, latched with shield, and gave up when no milk
could be nursed or expressed out. They were not eating for days. Moms were
afraid to give more than an ounce of formula in 12 hours, ( second mom) or use
expressed milk in a bottle, ( first mom) for fear of ruining their
"breastfeeding." These little ones weren't (breast)feeding though. One baby went back into
the hospital 12 hours after I saw the family, despite regular good feedings
with expressed milk, bili was 20 and ped sent them in, the other had a bili of
17( all feeds formula with a few drops of expressed milk, so far) and is
being retested to make sure it's on a downward trend. It's just an ongoing problem
that since bottlefeeding is the norm, any baby who stools 'adequately' in the
first few days, while getting formula in the nursery at night, is considered
good enough at feeding to go home. Intent to exclusively breastfeed with lack
of knowledge/follow-up about signs for determining adequate intake, means
these things happen. Sadly, in that sense, bottlefeeding is more "idiot proof" -
no bottlefeeding parents would put a drop of formula/expressed milk in there
and expect that to be enough food for 24 hours on day 4...
My heart goes out to this family Nancy mentioned, and all the others
struggling to feed well, and not getting the help they need.
Judy LeVan Fram, PT, IBCLC, Brooklyn, USA
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