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Lactation Information and Discussion

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Subject:
From:
"Jessica L. Callahan" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 13 Aug 2013 22:09:58 -0400
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I am in the middle. Research shows that feedings during the first 48 hours has a direct relationship with weight loss, transitional stool, and hyperbilirubinemia. So in a perfect world (no hard labor, no trauma at delivery, no medication usage, no swallowing of amniotic fluid) babies should 'want' to nurse around 8x in the first 24 hours - with the majority of those feedings happening between 10:00pm and 5:00am. 
In our no-so perfect world where babies experience trauma during labor and delivery, mother receives pain medication, babies love to keep amniotic fluid in their stomach, mother are 'bugged' all day long so at night time she needs to sleep - most babies don't get 8 feedings during the 24 hour period. 
Babies who have amniotic fluid do not 'show signs of hunger' and can go hours sometimes up to 24 without 'wanting' to eat. Because I know the result of re-admission tends to be higher for these babies I encourage mother to hand express every couple of hours and drip it into their mouths. When ask how much to give them - I tell them to keep going until babies closes his mouth shut firmly. Most babies will accept 'free' food that they don't have to work for. 

During the first 24 hours most of the nurses where I work are good with this plan. They do become slightly concerned if this is going on after that. 
I do find also that most supplements happen at nighttime as well and I really think this has a lot to do with the mother being tired and needing to sleep and a baby who is alert and possible fussy but not wanting to nurse or after nursing not wanting to sleep or a baby who does not want to let go of the breast. 

Jessica Callahan IBCLC, RN
NC, USA

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