Lyla,

You ask, "my understanding... 2 day old baby does not need these volumes - 
it isn't until day 5 or so that milk requirements "leap" up ....In your 
experience, is the situation different for a baby who is jaundiced and/or 
dehydrated?

That is a good question. In a one or 2 day old baby the volumes can be 
relaxed a bit and gradually worked up, as you say. (Normally we don't go 
around "prescribing" particular volumes for babies, but we might do for a 
baby in trouble). However, in my experience, by about day 3 or 72 hrs, the 
baby really needs to take more volume. It is ALWAYS A JUDGEMENT CALL and 
nothing is written in stone, however I have seen many babies whose parents 
don't realize that taking 1/2 oz every few hours just isn't going to do it.  
In my opinion, even after 48 hrs, normal babies are taking appreciably more 
volumes in. Just from observing the milk transfer/swalows/active feeds at 
breast.  Normal moms and babies kept together is not a worry in those early 
days, but the baby in question was 2.5 days old at high risk and was already 
"behind schedule" so I was thinking about the discharge advice.
Hope that clarifies my post. Warmly,

Laurie Wheeler, IBCLC, MN, RN
Tupelo Mississippi, s.e. USA

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