Rachel
This seems simple enough, but I bet you will get a few different responses.
Here's basically what I recommend (disclaimer: this is an historically bf
unfriendly environment and mom/baby separation is rampant):
I recommend rooming-in and bf on cue. Stating that the baby should be put to
breast whenever he fusses, frets, or puts hands to mouth and that he should
be awakened and offered a feed if he has not asked since 3 hrs. If we are
talking about a normal newborn, I do not recommend the waking at nite. Altho
I tell the mom to expect the baby to wake at night for a couple or so feeds.
The reason I recommend waking baby is to stimulate milk supplyk, prevent
engorgement, minimize wt loss, and prevent jaundice. Remember, most of "my"
babies are very delayed in initiation and often go to nursery. If babies
were continuously with mom from birth, I don't think I would have these same
suggestions.
I recommend that the mom allow the baby to nurse to finish first side first.
If the baby is still awake or giving cues, offer second breast. In fact baby
can go back again (3rd breast?), as some moms think that after giving left,
then right, it is time for formula. I tell the moms it is not a problem for
babe to nurse one side only if a good feed, however if she is full or
uncomfortable she can express to comfort. This usually not seen in hospital
but after going home and milk coming in. I also give moms an idea of length
of time of bf. I know this is probalby controversial but (again) I see many
moms telling me baby nursed one or two minutes and fell asleep, they call
this a feed. I know some babies nurse many times an hour, but this is a
poorly latched baby that just 'shut down.' So I let moms know that most
babes who latch well and give a burst of stimulus sucking will then go to a
slow suck pattern and nurse maybe 10-20 min. This has been my observation.
This is more than you wanted, I bet. ;)
Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA
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