To Formula Feed or not to Formula Feed ,; that is the question.
We all walk the fine line of when to supplement, when to wait.
Sometimes we behave in fear. Sometimes in stubborness.
But mostly we should behave cautiously. Everything we do ...or don't do has
consequences. Everything.
Giving formula to a breast baby has consequences. Not giving formula to a
breast baby has consequences. Weighing the pros and cons is a must.
Hospital based LCs , such as I am, are caught in another bind. It is called
protocols. And we don't always write them.
I happen to be an anti-formula gal. At least as long as I can get away with
it. I love the idea of spoon-feeding hand-expressed colostrum to an SGA baby
or baby who just can't get it together. I love the idea of "kangaroo care"
and how it stabilizes the VS and possibly even the blood sugar ( as a few
studies have suggested). I love giving confidence to mothers that their
bodies and instincts are working okay and it is okay to wait - but be
watchful. Let's count the diapers. Let's check the mucus membranes. But only
because it is part of the whole assessment. Let's count his toes again too,
because it's fun. Let's teach safe co-sleeping and stroking and touching and
loving.  I try to remember there are long-term consequences from formula (ask
Marsha Walker).
But I don't feel comfortable with a baby who goes longer than 48 hours
without food. Some would still be fine, I know. But some would not. And there
are some who would not be fine as long as 48 hours. Look at the baby.
At our facility we use a guideline of "48 hours and the baby will be fed .
Therefore we always start a mother pumping at 24 hours of age if the baby is
not feeding at breast. By 48 hours of age most mothers then have started to
collect some quantity of milk. It may be 5cc, 15cc or more. So the baby gets
fed by 48 hours and often no formula is used at all.
Before we use the slogan "First Feed the Baby" I think we should say "First
Look at the Baby" . And remember, do no harm.
Just some thoughts. Thanks for listening.
Cheryl Muller, RNC, IBCLC

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