I tend to see more engorgement in Mom/s who have epidural's, probably due to domino effect; IV fluids over a short period of time, sleepy, lethargic baby who does not wake to nurse very often.  So many of the Mom's have areolar edema for at least a day.

Those of you who work in hospitals- does your policy actual state that if babies nuzzle, lick, and are skin to skin, you do not have to document an actual # of minutes for a feeding? Is it acceptable to chart only one feeding in 24 hours? Do they check blood sugars? I have worked for years to get our policy changed. Right now the Pediatricians have been willing to "let a baby go"without nursing for 5 hours, then check the blood sugar and if it is above 40 (recently changed back from 50) they can go another hour, then if no feeding after that, formula or pumped milk needs to be given, at least 15 cc's. Would appreciate some ideas on how to get hospital staff, and physicians to relax about not pushing feeding in the first 24 hours. 

Dianne 
RN FACCE IBCLC
Florida

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