In a message dated 11/5/2007 6:08:13 P.M. Eastern Standard Time,  
[log in to unmask] writes:

The  problem is, when it gets to be any longer than 5-6 hours and an infant 
has not  yet breastfed since birth, everyone gets nervous and will not hold off 
giving  the supplement, including physicians.  In all of the literature I am  
looking at, the mantra is it is not necessary to  supplement unless  
medically indicated

Dear Friends:
 
The Academy of Breastfeeding Medicine has a lovely protocol on this topic  at 
_www.bfmed.org_ (http://www.bfmed.org) .
 
If a baby has to be supplemented, and has been s2s, it is easy to have the  
mother hand express some colostrum into a spoon or a 1-cc syringe and feed that 
 to the baby. Then everyone is happy: mamma (who sees she has milk that is  
valued), baby (who gets the right food), and healthcare staff (who see a fed  
baby with a lovely blood sugar).
 
Babies can go at least 6 hours without being fed. See this article by  
Diwakar et al.
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nMethod: A total of 200 healthy, term, AGA infants were  longitudinally 
evaluated at 3, 6, 24,  and 72 hours of life. Plasma glucose was estimated from 
heel prick capillary samples. The influence of mode of  delivery, parity, and 
interval between feeds on plasma glucose was analysed. 
nResults: There was no significant difference between the  plasma glucose 
levels of the cohorts at  any of the sampling time points. Parity, mode of 
delivery, and time since the last feed did not affect plasma glucose. Satisfactory 
glucose levels were maintained even when  infants remained unfed up to 6 hours 
of age. 
nA term, breast fed infant may have its own distinct  plasma glucose levels, 
showing no  significant variation between 3 and 72 hours of age. Plasma 
glucose levels are satisfactorily maintained in normal  term infants without resort 
to prelacteal feeds. Mode of delivery, parity of the mother, and interval  
between feeds did not influence plasma  glucose. 
nBiochemical thresholds for  hypoglycaemia do not seem to be of practical 
importance in asymptomatic, normal, term, breast  fed infants. 

nArchives of Disease in Childhood  Fetal and Neonatal Edition 2002;87:F46-F48 



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Babies kept s2s are being fed metabolically and energetically by their  
mother's body, almost as if she was still pregnant. A baby that hasn't eaten  must 
be kept s2s so its temperature and blood sugar and heart rate and oxygen  
saturation stay at optimum levels.
 
warmly,

 
Nikki Lee RN, MS, Mother of 2, IBCLC, CCE, CIMI
_www.breastfeedingalwaysbest.com_ (http://www.breastfeedingalwaysbest.com/) 
www.myspace/AdonicaLee



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