thanks to all who responded to my queries last night about kangaroo care. i
feel like i am much better informed than i was, and here is the short answer
to why kangaroo care wasn't working with this little girl - lack of nursing
staff. they were busy and no one had time to bring warmed blankets or see if
this baby was covered up enough, so they went to their fall back position -
nursery and bottles.

i spent seven hours with the family today and achieved what i think is a
moderate success. yesterday some helpful person hooked the mother up to a
hospital pump at the highest setting for fifteen minutes, causing her so much
incredible pain that she had not tried to pump again (plus no one showed them
how to use it). only drops of colustrum were pumped.

to back up a bit - mother delivered by C/S at 36 weeks due to severe PIH; baby
was SGA, about 34 weeks in size, moderately good apgars, 4 lbs. 4 oz. at
birth. they began supplementing baby with formula from a bottle. today at the
parent's request i went to the hospital where the following took place(baby's
temp had stabilized):
-got baby successfully latched on and sucking actively (mother's vision was
severely impaired from meds and she couldn't see to do it well enough - also
flat nipples)
-obtained lanolin and used the pump at a lower setting without pain
-got father and mother able to get baby successfully latched on
-got an absolutely INCREDULOUS neonatologist to prescribe breastmilk, went to
milk bank, got breast milk, and got back before next scheduled comp feeding
-by this time the formerly sneering nurses were interested and helpful, even
went so far as to offer an SNS but they didn't have any. got the baby switched
to the haberman. this is a Great teaching opportunity as parents can see
better the difference between standard bottles and the similarities to feeding
at the breast.

these parents were lucky, this baby was eager to nurse. when i prepared to
leave, their "favorite" nurse said she would be stuck in the nursery all
shift, because there were six babies and two nurses, so, you know, "my time
will totally filled by changing diapers and feeding, changing diapers and
feeding." but i didn't scream out, why aren't they breastfeeding, show me the
mothers. i didn't ever even raise my voice with anyone (just kidding, i am
quite nice when it is important).

the neonatologist said, and i quote, "i have never had ANYONE request this,
how could it hurt for just one more day to use formula?" i answered that i
would be happy to send her some propaganda, and she replied "I've SEEN that
proganda" and obviously didn't believe it, huh? just wait until the day when
she has to write the prescription for the FORMULA and not the breastmilk!

i can also see that several nurses were genuinely interested in helping this
mother breastfeed, but didn't have enough time and or training. they have only
a weekday parttime LC - too bad these babies still insist on getting born
during off hours. it will be a great day when all hospitals think an LC is as
important as anyone else to have around all the time.

yeah! another one breastfeeding

carol b.