Hi, all

Amy asked:

>what is the
>reasoning for waking a newborn to breastfeed while in the hospital?

My guess is that from the hospital standpoint, this is an effort to make
sure that these babies don't go home dehydrated. A valient cause, no doubt,
but perhaps a little over-zealous in their prevention methods.

Seems to me that IF mom and baby are together 24 hours a day--preferably in
bed with each other--and IF mom is taught how to recognize subtle cues that
her baby is ready to feed, then she could pretty much feed on "demand." She
would need to be taught to look for a light sleep stage--eyes moving under
eyelids, mouth making sucking motions/noises, fists to mouth, etc. A baby in
this stage is generally more than willing to nurse. If mom is assuming that
baby will cry when he is ready to eat, then she is waiting too long and may
miss feedings that baby needs.

I would think it would also matter whether baby has had any good feeds.
Often a newborn who nurses long and well soon after delivery will sleep for
a long time after that (labor is hard on them, too!) and "missing" a feeding
is okay.

And then there are the babies--like the boys who are circumsized soon after
birth--who basically shut down and sleep very deeply. I don't know what the
best course of action would be on these babies, other than to hold them
skin-to-skin and hope for that light sleep stage to cycle through.

To routinely wake a sleeping baby by the clock though is just asking for
trouble. If mom tries to wake a baby in a deep sleep stage, at least 2 folks
are going to be frustrated. And that frustration could be compounded if a
well-meaning nurse makes a note that the feeding went poorly and plants the
idea to mom that there is something wrong with the way she is breastfeeding.

As a non-RN IBCLC, I've found that one of the most frustrating aspects of
working in hospitals is that the hospital setting is about documentation,
which leads to policies that specifically define (so many times in so many
hours for so many minutes) things that I think can usually be a little more
relaxed. And at the same time, I can see the value in having some way to
chart what is going on in a way that is meaningful to the staff who is
working with a mom. Seems like the more knowledgeable about breastfeeding
the staff is, the less binding the documentation policy.

Just my two cents+++ worth!

Melissa Vickers, IBCLC
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