Hi Beth,
I can see how this nurse was puzzled. She might have been thinking that
you were advocating huge volumes, which of course would demotivate the
baby to bf, rather than the 10-20 drops of colostrum by spoon that we
usually use to jump-start sleepy newborns.
Try using your communications skills training with this nurse. Be
empathetic to her concerns and point of view, draw out her worries,
affirm that those are common concerns, and then address the
misunderstanding or misinformation. If she feels like you are respecting
her, she is more likely to respect you, and to listen. Once you have a
collegial relationship (if possible, some people do indeed lack
relationship skills!) you can address your own feelings about her
challenging you in front of a mom.
And as for the answer to her question, a few years ago a Lactnetter
posted the change in her grandbaby's blood glucose after a feeding of
colostrum. If you could find that, it would give her an idea of the
magnitude and timing of the effect. Perhaps that person is still on
Lactnet. In my own practice, a few spoonfuls of colostrum drops then
skin to skin with mom usually wakes the sleepy baby up within about 20
minutes. If you can get baby to lick the colostrum off the nipple, so
much the better, but then you wouldn't usually need to give expressed
milk, because the baby is awake and actively trying to feed!
Catherine Watson Genna BS, IBCLC NYC cwgenna.com
On 2/15/2011 4:54 PM, beth mcmillan wrote:
> Hi Everyone,
>
> Have a kind of strange question put to me by a nurse who was obviously sceptical of my advice to a mom to try offering a bit of pumped milk to a baby prior to offering the breast - we know that it can help to calm and organize a frantic hungry baby (it isn't the only thing I suggest but is in my 'tool kit' as a strategy for some kids). I talked about how it can give a sleepy baby energy and stamina to perhaps feed more effectively at the breast. Discussed the 'finish at the breast' method and all the reasons it can helpful. The nurse questioned me (in front of the mom - geez) stating that the baby would be less motivated, etc..... She then wanted to know how long it took the baby to convert the calories taken in via the supplement to energy that would allow the baby to be more energetic at the breast. Huh?? I told her that the calories taken in were immediately helpful to perk up the baby - she said that was not the case. I asked her about babies with low blood sugar, we stopped the conversation then as the mom, who was present, stated that my idea (well not 'my' idea but accepted practice) made sense to her!
>
> Is her statement about converting calories to energy a valid one?? Am I missing something? Would love to follow up with her........and have plans to forward info but wanted to see what you all had to say about this specific question.
>
> beth
> IBCLC and LLLleader in Ottawa
>
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