Dear Becky
 While this is not an official standard at our hospital the general
practice
 is...
 1.  If an infant has not had a succussful breastfeed in 24 hours (as in
 latched on correctly and sucking and some swallowing noted, with no
 progress towards one either) the mom is instructed to begin pumping.
 2.  Mom is still encouraged to offer breastfeeding every 2-3 hours, or
skin
 to skin if not successful.
 3.  If baby exhibits signs of hypogylcemia a heel stick glucose is
 obtained.
 4.  If less than 40, mom is encouraged to pump and the resulting EBM is
 given per cup or syringe to baby. (also, if no EBM is obtained 10-15 cc of
 ABM is offered in the same way.  NOTE--only in less than 40 Blood sugar.
 5.  If baby is alert between feeds but just needs longer to get
 established, we just reassure the mother and encourage freg attempts to
 feed, save any EBM for the future, and referral for home follow up.
   This is mostly what happens, altho I've been told via the grapevine that
 some RN's just give formula and don't document it.  ARRGGHH
 Lucy

> ----------
> > From: Becky Krumwiede <[log in to unmask]>
> > To:
> > Subject: Re: Time till the first feed
> > Date: Tuesday, October 14, 1997 3:14 AM
> >
> > I'm finding this conversation interesting because it's something I
> struggle
> > with all the time.
> >
> > >  On page 7 of the WHO/UNICEF publication Protecting, Promoting, and
> > >Supporting Breastfeeding, there is the statement that "under normal
> > >circumstances the neonate requires no water or other food whatsoever
> > during
> > >the first 2-4 days after birth while lactation is being initiated."
> >
> > I guess I've always interpreted this as meaning that IF the baby is
> > breastfeeding and taking colostrum, that's enough, no additional water
or
> > food is required.  I think Pat Drazin's question was in regards to a
baby
> > who is NOT breastfeeding--how long can we wait for baby to initiate
> > feedings?  I don't think I'd wait 2-4 days if baby is NOT
breastfeeding.
> > We tend to start feeding normal size/gestation babies at about 24 hrs.
if
> > they're not feeding at the breast.
> >
> > But then Pat Gima writes--
> > >I'll share a theory of mine.  I believe that, as others have said,
there
> > is
> > >protection from fluid loss in the newborn "under normal
circumstances."
> > >But if there is anything by mouth, such as water, the system is a
"go,"
> as
> > >in urine loss. . .  I work with a lot of babies born at home and they
> hold
> > >their fluid until feeding gets going.  I haven't seen any of them with
> > >signs of beginning dehydration.
> >
> > I'm intrigued (!) and interested in what anyone else thinks.  If Pat
has
> > seen 3-day-old non-breastfeeding babies who are not dehydrated I
believe
> > her.  Because we start feeding non-breastfeeding babies at about 24
hrs.
> of
> > age in my hospital, if her theory is right, I would never see such a
> thing.
> >  I HAVE seen some dehydrated babies at 3 days of age who were
> theoretically
> > feeding (at the breast trying very hard but getting little) but maybe
> > because they were sucking they set everything in motion.  Hmmmmm.
> >
> > Becky Krumwiede, RN, IBCLC, Appleton, WI
> > [log in to unmask] or [log in to unmask]
> >