Maureen, what a great post.  I have seen your pictures and they are so  
heartening.  I am wondering about when the babies are not breastfeed.   Either 
because the mom is not there for all the feedings or moms who do not  breastfeed, 
do the nurses use paced bottle feeding?  Also, does the parent  get taught 
paced bottle feeding?
In most NICU or Special Care Nurseries I have observed that a calculated  
amount is determined a baby needs in 24 hours and this is either divided over 8  
feedings or less.  Babies are feed either every 3 hours and many are moved  to 
every 4 hours.  
This is just not the physiological norm.  Babies are meant to have  small, 
frequent feedings.  I know there is the issues of letting babies  rest but 
moving them to every 4 hours only leads them to be unhappy between  feeds and 
reflux.  Splitting the feeds up to every 2-3 hours cannot be that  difficult to 
achieve and babies would be far better off.
I have tried to approach the staff at the Level II nursery where I work  
about paced bottle feeding and more frequent feeds but am not well received on  
either subject.  The OT/PT person loved Barbara and Kay's video on feeding  but 
she also feels intimidated by the nursing staff in the nursery.
How do we make these changes?
Thanks,
Ann Perry, RN IBCLC
Boston, MA

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