June asked: > I looked after a woman to-day who baby born at 36.3 days, now 3 days = not going to the breast and requiring ebm top-ups working from the = guidelines. I worked out that the baby needed 42 mls per top-up. = consider the capacity of the baby stomach. I am concerned that I dont = have the correct information to give mothers and the staff. < I am assuming the 42 mls was determined by the weight of the baby and not being a 36.3 weeks or size of baby's stomach. June's comments has brought up something that I am seeing at the hospital I work and especially with the neonatalogist. They want to determine what a baby needs by cal/kg. My argument with them is that this cannot be factored in until the baby is at least 3 days old. In the first 2 days of life (and sometimes more for some babies) newborns' digestive systems are just not capable of handling large amounts of food. Once they have recovered from delivery than larger amounts adjusted to cal/kg can be factored in. I liken the newborns digestive system to women in labor or people who just came out of surgery. I base this on all the studies and the observations of newborns. We all know that the average intake of the newborn in the first 24 hours is 7-10 cc/feeding. In the second 24 hours the average intake goes up but still 7-15 cc/feeding. Also, the composition of colostrum is high protein with lower fat and sugar than mature milk. My argument to the neo is that a newborn in trouble does not need larger po intakes because they just can't handle it so will need an IV. What do others think? I would especially like to hear from some of the pediatricians in our group. Ann Perry, RN IBCLC Boston, MA *********************************************** 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