The discussion of waking newborns is great because this is a real issue.  The
sleepy baby is not always safe to leave alone.  If he is in a normal sleep
cycle, of course explain this to the mom.  I worked with one yesterday who
fed well after delivery now at 5 hours was sound asleep.  My contribution as
an LC was reassurance and explaining infant state.  However, I also explain
that our hospital policy is that babies must be fed or attempted to feed at
least every 4 hours.  So I recommend gentle stimulation to attempt to feed
during the day and evening then going every four hours at night.  To chart
breast-feeding we use the Good BF, Fair BF, poor BF, and Attempted BF system.
 It has helped us tremendously in not intervening with formula because the
baby didn't eat.  I come in the morning and see ABF and PBF so I know I must
work more with this mother.
    I would like to comment on "stripping clothes off babies."  I take the
shirts off and teach the mothers gentle infant massage with the baby on the
chest between the breasts. A warm blanket is over both so the baby doesn't
chill.  All that skin contact with a loving mother often works to awaken the
baby.  I do not see this as negative.
Judi Hall, RNC, IBCLC

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