Dear Barbara and Lactnetters,

    Thanks to Barbara for writing a succinct post regarding the feeding (or 
lack thereof!) behaviors of 36 weekers.  Since I often inherit the outpatient 
results of this group, I get very frustrated when parents have not been 
apprised of the need to consider these babies "big preemies" when it comes to feeding 
abilities in most cases.

     The mothers are  often ANGRY that they were not informed to watch or 
compensate for feeding abilities.  At first, the parents are a little skeptical 
of the possible need to pump pc or offer supplement since the hospital LCs or 
their ped did not underscore any issues.  But then they GET IT and are really 
miffed that their BFing experience may be have been undermined.   

    Luckily, I am quietly educating the peds and ob/gyns about the need to 
watch these babies.  If they never get reports about the WHY of breastfeeding 
difficulties as it relates to pre-terms then they lump it in with all 
breastfeeding casualties.  Many HCPs I have sent reports to comment on "I wasn't aware 
of....."  or "thanks for pointing out the relationship of........" when I give 
my "impression" on why I think this scenario exists and how the feeding plan 
can help remedy the issue at hand/breast.   Since I see many of these cases of 
slow or no weight gain and subsequent low milk supply I can think of no better 
way to try to keep it from reoccurring especially when the referral has come 
from the HCP.

    Keep up the great posts, Barbara.  

Jan Ellen Brown IBCLC
Iced in in Charlotte, NC USA

    

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