Hi Kimberly,
Welcome to lactnet. I have heard some folks say that the 'average' amt of
colostrum in first 24 hrs is 37 ml (or maybe 17 ml). I can't remember. I
have found that this makes nurses even more sure that babies need
supplementary feeds.
All I know is that there is a huge variation in amts that can be expressed
(hand or pumped). Some moms express 1 oz the very first expression on the
very first day (for example for a prem baby) and some moms and the skilled
LC cannot express one drop even after several days.
In a talk geared towards trying to get the nurses to promote/support
breastfeeding and to stop unnecessary supplementation, I personally would
not talk about the amts so much. I would focus, rather, on the practices
that should now be standard of care. You can print out AAFP, AAP, ACOG,
AWHONN (USA medical orgs) and other statements that support early,
unrestricted feedings. Also of course ILCA Evidence for the 10 steps, the
first 14 days, BFHI 10 steps, and other such guidelines.
I would also focus on position and latch, and assessment of feeds and how
poorly it is now done (I'm just guessing, but bet they are not highly
skilled at this). And that mother- baby separation and nursery
interventions greatly interfere w/ baby's access to the breast/colostrum etc
etc. I usually say if the latch is good, and the flow is good, the baby will
get the colostrum. If he wants more, he will cue for more. If he is there w/
mom and unrestricted, he will get what he needs. This is basically true,
altho there are a few situations where a complementary/supplementary fdg is
needed (medical indication).
In other words, I would bring them up to speed.
Good luck.
Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA
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