We don't have any written protocol on bf pemies but we do make some
recommendations to the pediatricians and to the mothers "when we can":
Some MD's more prone to go along with the recommendations than others. I
try to talk to the mom about her options so she can "pressure" the pedi
to go along with it.
I suggest , if the baby is stable enough to be held, that she hold the
baby skin to skin and place the baby near her breast. If he roots and
acts as if he would suck, we don't stop him.  If the situation is a baby
that is just beginning to be fed by means other than gavage, this is
strongly encouraged.  Some peds are stuck on giving the baby a certain
amt of fluids that is measurable , so I always suggest letting baby try
to latch on and use a fdg tube attached to syringe, slip it into his
mouth as he is on the breast and syringe feed him the ordered volume..
The moms typically can't visit but once per day anyhow, if they have
already been discharged home, so most docs are willing to let her
breastfeed that one time at least but seems like we have to suggest it
or they won't think about writing an order to do this.Would be nice if
all MD's felt the same way and we could have a set of policies that they
would all follow for BF protocol of premies/sick newborns.
Kathy Birt,RNC
LactationCenter Mother Frances Hospital
Tyler,TX

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