I'm rather recently employed at a tiny community hospital where the policy
involves having a mother pump after a certain amount of time has passed with
no latch-on and giving the infant whatever colostrum is available from
pumping.

What I've noticed is that the colostrum gets stuck on the flanges and
connectors to the collecting bottles, so how is it available??  Then the
 nurses end up finger feeding with D5W which I'd like to discourage.  If the
baby's glucose drops below 40 and there is no successful latch-on policy is
to give D5W but too many babies are getting this just because the colostrum
isn't easily collected via pumping.

I thought I read in the Baby Friendly material that if a baby doesn't
latch-on after six hours to HAND EXPRESS and collect the colostrum in a small
cup to give to the baby. This makes so much more sense.  I've been talking
some of the moms I've seen through the how-to's of hand expression but I
don't even know if all our staff nurses know how to teach this.  We are so
technology oriented that I don't think it crosses anyone's mind to  teach
hand expression.

Now I can't find where I read this suggestion.  Is anyone familiar with it as
Baby Friendly or could I have read it in an journal article?  As usual,
change needs to be justified even though this seems obvious once you realize
it.

Also, all the Baby Friendly guidelines talk about 'skin-to-skin' which I have
always felt strongly about.   Ashley Montgu's TOUCHING emphasizes this.  Does
anyone know of any articles or references to the effects of skin-to-skin
contact on the baby and the ability to latch-on?  I'm going nuts because our
mothers are birthing in nursing hospital gowns with those slits and a panel
right down the center (unless they remove them themselves during labor).  How
are the mother and baby going to feel each other's skin with all that
material in the way??  I thought Ludington's Kangaroo Care book would have
references to skin-to-skin but the Index disappointed me.

Mardrey Swenson
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