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Lactation Information and Discussion

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From:
laurie wheeler <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 2 May 2012 22:06:57 -0500
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In the USA (not sure if you are here) many doctors use the book called
Harriet Lane (?textbook or handbook of neonatal care?). This is the
book found in many USA nicus, to which neonatologists and medical
students and residents turn to for answers about FEN -- fluids,
electrolytes, nutrition.
Keep in mind, the infants being treated under the guidance of this
book are sick or premature infants.  Although a general pedicatrician
might refer to this for a well baby, when trying to decide how much
said baby needs.
I believe there are protocols or algorithms re feeding preterm, early
term, and term infants put out by Academy of Breastfeeding Medicine
and/or Dr. Wight's group in San Diego California (toolkit).  That's
where I would start.

You might make some inroads just by encouraging skin to skin care, and
spoonfeeding of expressed breastmilk every 2 hrs to otherwise well
infants not breastfeeding effectively. Hospital staff, doctors, and
mothers alike need to be shown that there is usually *much more milk*
than what they can express in a few seconds. I have surprised many a
mother and even myself, when after RPS, and with steady determination,
expressing and switching back and forth, we collect a good bit of
colostrum.
FYI I use a plastic "teaspoon" from our kitchen and ask mother to
express and spoonfeed 5 to 10 "little puddles of milk on the spoon"
from each breast every 2 hrs until baby starts latching and feeding.
Observe baby for any s/s of illness, of course.

Laurie Wheeler RN MN IBCLC
Mississippi USA

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