hi ann
as a retired nicu nurse, now an LC, i wanted to comment. in the usa, most
premies are not given the large volume feeds that Pam in Africa is used to.
i think the feeling is that it would compromise the cardio/pulmonary status
due to fluid overload. but  maybe that could be tried and then hmf would not
be needed. also mothers are asked are you going to bf, but why not just ask
for the milk, make it an expectation (more below on parents in the
nurseries).
also re KC: yes some babies are unstable right at first, but the USA medical
model and the kangaroo mother care model are very different. i hope you have
seen some of the kangaroo care unicef films from south america. the babies
are much more stable than when they are 'laid out' in warmers and incubators
and subjected to many many interventions. you said it yourself that "maybe
my nursing back ground...colors my reading of these articles..." This is not
a flame or a criticism, but I think you are right. Over the years I have
come to see that what my experience was in the medical model of childbirth
and newborn care is not the only one nor the best one. I have become more
open to other cultures of care. For example, today many usa hospitals do not
really do rooming in. Lots of other countries do "bedding in" and all the
moms and babies are in bed together from the moment of birht til discharge.
Most nicus don't do rooming in until the day before d/c. Breastfeedings are
often rare. Moms and dads are not welcomed into the units freely. Many
primips who have "feeders and growers" could be rooming in instead of
visiting infrequently. many jaudniced babies are treated unnecessarily
(technology) and separated from parents. why cant't the moms room in and bf
ad lib? Many mothers cry that they must leave the baby and the docs reassure
them Oh they just need two more days of antibiotics. why can't the mother
room in with him? I bet I am not far off on your hospital's culture of care.
I guess this turned into a bit of a rant. I think the technology is great
but sometimes overused and making us think we can't do w/o any of it.


Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA




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