Hi Lisa

I see plenty of babies who have been born with vac assist - usually in
combination with an epidural.  I red-flag these babies as many of them do
not suck well in the first 24 hours - regardless of mother's nipple type.
These babies usually root well, but have their tongues bunched or have
little coordination of tongue movement.  We keep them skin-to-skin and give
expressed colostrum via teaspoon and try to facilitate self-attachment.  We
save any further interventions for day 2 if necessary.  Usually they do fine
in the second 24hours.

Jean Ridler  RN  RM  IBCLC
Cape Town

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