Hi Anne
I would recommend continuous skin to skin and mom to hand express about
every 2 hrs and syringe or spoonfeed to baby. I would try reverse pressure
softening prior to expressing or latlching, since you said the areola is
lumpy or puffy. If the volume of colostrum is very low, like less than 10 ml
every 2 hrs, then I might even add a few mls of sterile water to extend the
volume a little if it would help baby pee and also get the nurses off her
back a little. The parents could refuse to send baby to nursery. They could
let the doctor know they are not being supported and they are actually
afraid the nurses will secretly give formula.
After 24 hrs, if baby is not latching more effectively, mother might try
using a hospital grade electric pump one side at a time while continuing
skin to skin holding.
Make sure they get early follow-up and watch baby's weight and jaundice.
Laurie Wheeler, RN, MN, IBCLC
Mississippi USA

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