Judy Dunlap asked for inpatient protocols for breastfeeding--especially when
those newborns don't nurse well in the first 24 hours.  Judy, this is my
biggest concern also.  I thought I sent you a message earlier, but I don't
believe it actually got sent.

Have you seen the following two references:  Yamauchi and Yamanouchi,
Breast-Feeding Frequency During the First 24 Hours After Birth in Full-Term
Neonates, Pediatrics, Vol 86, No.2, Aug, 1990, p. 171-175  or Glover, Jacki,
Supplementation of Breastfeeding Newborns: A Flow Chart for Decision Making,
Journal of Human Lactation, June 1995, p. 127-131.

At one local hospital, they have solved this "problem" by sending most moms
home with a SNS--just to make sure that the baby is "getting enough."  I
certainly can understand the concern, but talk about too much equipment and
undermining everyone's confidence.

I, in fact, feel like I have probably got too many moms started pumping in
the hospital, because their babies are sleepy and not latching--yet.  In the
part of my life where I work in the pediatricians' office, I am able to
personally follow-up on these babies after they leave the hospital.  So many
moms tell me that their babies really started nursing well on the third day
and that before that they were just going through the motions.

Judy, if you get more references/enlightenment on this subject, would you
please let me know.

Thanks.

Toni Pestro, RN, BSN, IBCLC