1). I prefer that if baby is going to get a bottle for supplements, that a small bottle feeding come first. Especially if baby is one of those 36-37 weekers we are talking about and won't wake or rouse well to feed well. Just using a little like this helps wake baby and will usually encourages her to nurse more vigorously. Or so I have found in my practice. When we put a sleepy or frantic baby on the breast who can not extract milk well, and then bottle feed after nursing, we often end up teaching baby to wait for the bottle. Plus, mom tends to give too much in the bottle after nursing because "baby is still hungry." 

2). As far as supplementing these poorly feeding 36-37 weekers who are starting to slide downward. Of course, we don't want to jump in to quickly to supplement. But I would like to say that we as the readers of these posts are not there with the mom and the doctor and don't know all that is going on. I have seen early supplements work wonders to rouse a sleepy baby and get her to the point of nursing beautifully a day or two later, and like the rest of you I have also seen supplements kill the breastfeeding (especially those 2-3 oz given after "nursing").

My favorite way of supplementing these poorly feeding babies in the first few days of life is to do it at the breast with a periodontal syringe or syringe/feeding tube device. That is if baby will rouse and latch and attempt some sucking. This teaches the baby to actively suck to remove milk and rewards them for being on the breast. And I like to use a bare minimum of supplementating, maybe 10-15 cc total divided between the two breasts. To me this is easier than playing catch up when baby is 5-7 days old, very lethargic from poor intake, 12% weight loss, no bowel movements, and who now can't suck well enough to feed herself.

Kathy Eng, BSW, IBCLC
Houston, TX USA


             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html