>>> Terri Klein 12/31/2009 8:25 am >>>
Dear Lactnet members,
I tried posting a message a few days ago but didn't see that it came through, so am trying again. We do a lot of epidurals here and more often than not they are continuous throughout the labor unless she is not pushing effectively or does not have the feeling to push. I get these sleepy baby that has no interest at all in feeding. Often times they are gaggy, the staff has delee suction a good amount of fluid before I even get  a chance to see the couplet. By this message you can see I work in a hospital setting. 
Skin to skin is my priority, I usually have mom try to manually express drops into a spoon so that she can offer drops every hour until this baby starts to show signs of hunger. 
Often times when I revisit baby is being held by visitors no longer skin to skin. Still sleepy and because there has been many visitors she has forgotten to give any more drops. I can't always visit every hour. 
This means that this baby might have fed within the first hour of birth but not again for 8-12 hrs. Where is the limit of time to let these babies go before having to offer supplements. Usually within the 12 hours they are starting to feed and may have 5-8 feedings before discharge of 24 hrs with 2-3 voids and stools.
I just don't want to be slacking on this. Our C/S moms have baby skin to skin in about an hour when they return from recovery. We hold the bath until the first or second good feeding. I try to let baby do the lead with feeding and just guide in positioning. I auscultate swallows during a feeding and try to observe 2 or more full feedings before they are discharged.
Your help will be greatly appreciated. I believe I probably asked this before but my mind is getting too ful and can't pull this one out of my head.
Thanks, please feel free to email me privately as well.
Warmly,
Terri Klein RN, IBCLC, RLC

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