This is a tricky one to discuss, because so much depends on the local
circumstances and what the observation of the mother/baby pair tells us.   I
look forward to seeing what others have to say on this issue.

I hope I m not opening a can of worms here, but if supplementation is really
necessary (for the baby's sake or for the doctor's sake!) *during the
colostrum phase*, I like to use what I call a colostrum enhancer - glucose
or dextrose water to which one, two or three drops of colostrim are added -
whatever the mother can produce - given to baby on a teasooon usually.   I
feel this has far less of an impact on the mother's confidence.  Of course,
some mothers have oodles of colostrum by day 2 and then an "enhancer" is not
necessary.  Once past the 3rd or 4th day, and a baby needs to be
supplemented, I would use formula - reluctantly, but the baby has to be fed.

Not so long ago babies were nil per mouth for 24 hours after birth and did
okay.  Fortunately I rarely need to suggest the use of supplements.  I
mostly see babies from 37 weeks to term - from Day One to about 2 weeks.
(Our exceptionally high Caesarean rate means that many babies are scheduled
to be born between 37 and 38 weeks.)

Jean Ridler  RN  RM  IBCLC (Private Practice)  Cape Town

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