I'm following this with interest.
Some points haven't been brought out so far in the discussion.
If we're talking about a normal, healthy baby not feeding in the first
'however long', what are the nurses/LCs doing to the baby? In other words,
is the baby getting frequent blood sugar levels done, is the baby being
given something else because they're low or 'might go low' because he's not
feeding?
Our policy is to leave a baby without feeding for up to 12 hours (doing
obs, and at 12 hours doing a BSL). Now if that BSL is low the baby will get
a formal sample taken and the paediatrican notified - and, sure as eggs,
you can bet the baby will be ordered to have something, which we probably
wouldn't be happy about.
I totally support the skin-skin, let nature take it's course philosophy,
but if baby still hasn't fed by eight hours (or even 6 - not before) then I
will encourage the midwives/mother to hand express - and we all jump up and
down excited if we get 2 ml in a syringe. It's not even a finger-feed then
to give it to the baby, just a trickle in the corner of the mouth. And it
keeps the BSL up and the doctor away!
(Since starting to write this eamil I've read Jan's response - we agree
about considering the baby in all this. Don't know why you don't want to
discuss hand expressing though, but in my experience 'getting no milk' even
once is very rare and unheard of 6 to 7 times)
Now I did start this by saying the baby was a normal healthy neonate. But
what is that these days?? Just how many normal, healthy babies are trying
to get rid of intrapartum drugs for days afterwards? Sometimes the
skin-to-skin, let nature take its course has a lot to battle against.
My other point is preventing engorgement. We all know that frequent,
effective breastfeeding from birth will prevent engorgement and that not
draining those breasts often enough in the first 48 hours will cause
engorgement. So I can't see a thing wrong with starting to express from 6
or 8 hours and continuing regularly - until the baby is awake enough to
suckle.
I also totally support Heather in regard to hand expressing. It is gentle
and not nearly as invasive or personally threatening as an electric breast
pump - at this stage!!
Denise
Brisbane, Australia
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Denise Fisher, BN, RM, IBCLC
BreastEd Online Lactation Studies Course
http://www.breasted.com.au
mailto:[log in to unmask]
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