For those of you who work in hospitals, I'm wondering if this is an issue for anyone else out there. RN's that tell moms to bfd every 2 to3 hours instead of on-demand, and scare new mothers if the baby has slept more than 3 hours and convince them to give formula because baby missed one feed.
I think breastfed babies do not nurse every 2 to 3 hours, especially in the first few days, I think they tend to cluster feed more often. Often, many babies do not nurse as frequently during the first 24 hours, many are very sleepy, but then they will feed more frequently on the second day. I personally do not worry if the baby nurses just 5-6 times in first 24 hours, but they then wake up more and nurse frequently on the second day. Has anyone else noticed this too? But then they should be bfding at LEAST 10 times per day.
I am looking for information or studies to back this up, for MD's and RN's at my hospital who still really want to tell women to breastfeed every 2-3 hours. IMHO, it really sets the mother's up with false expectations of how their babies are going to breastfeed during the first couple days. Then they are frustrated when the baby "is fussy" after feeding, and the baby is missing lots of feeds because mom is missing feeding cues. So baby doesn't get as much colostrum as he should, maybe starts to develop jaundice, and then breastfeeding is blamed. Or mom supplements with formula "because she doesn't have enough milk."
First of all, we need to be telling these women to breastfeed on demand or on cue. Secondly, that when the baby is awake they will probably breastfeed almost continuously, the same way that they continuously swallowed small amounts of amniotic fluid in utero, then they will sleep for awhile. And babies won't starve if they don't eat a lot in the first 24 hours, but I think they should be getting to the breast very frequently by the second 24 hours.
So I'm wondering -
1. Am I right about this feeding pattern? What is the typical feeding pattern in the first few days?
2. Is there any research to back this up?
3. How do you explain normal feeding patterns in hospital to new mothers?
4. And lastly, how do you document feeds in hospital?
I don't like our forms at all, first they say "breast" and "bottle" in column format, so we should not be giving forms that say bottle on them to bfding mothers. But secondly, just putting down a time for a feed is difficult to do, I think, for breastfeeding because when it is going well, often the baby will nurse almost continuously, sometimes for a few hours and then sleep for a long time. How do you document that to make RN's and MD's happy? Any forms that are more compatible with the normal course of bfding in the early days?
Thanks for your help
Tricia Shamblin, RN, IBCLC
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