Dear Friends:
There is a baby in a NICU who is term, 10 pounds, and was delivered by
cesarean section after he failed to descend. Labor was spontaneous. Turns out
the cord was wrapped around his feet and legs.
He has RDS, and possible pneumonia.
He went s2s today, and immediately dived for the breast. His saturations
stayed in the 94-100% while he was s2s. He would latch on and suckle for 30
seconds, and then come off and breathe hard until he'd caught up his oxygen
level, then he'd dive back to breast. His respiratory rate at best is in the
60s; in between bouts of breastfeeding it was in the 70s. It is obvious that
he is working hard to breathe.
The PNP and nurses in the NICU said that breastfeeding was too stressful
for him, that he would have to be bottlefed because it is easier.
I was amazed at seeing this big baby boy, one day old, be so vigorous
and have such trouble breathing. I know that big babies can get into serious
trouble. I also know, having taught his parents childbirth class, that they
intend to breastfeed and I want to do everything I can to help them achieve
this goal. I discussed gavage feeding with the mother as another option. This
boy won't be fed anymore for at least another day.
Now for my question: the staff said that Meier's work showing that
breastfeeding is easier was all done on well premies. As this boy is sick, that
research doesn't apply. Dr. Wight? Anybody? What does the evidence say about
this?
I also don't understand why it is alright for him to suck on a pacifier
but not the breast.
warmly,
Nikki Lee RN, MS, Mother of 2, IBCLC, CCE
Maternal-Child Adjunct Faculty Union Institute and University
Film Reviews Editor, Journal of Human Lactation
www.breastfeedingalwaysbest.com
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