Hi all,

I have searched the archives and come up with
 some very good info, but am posting to the list for any other
suggestions.

The office manager for our neonatologist is interested in breastfeeding
after breast reduction surgery.  The MD she works for is very pro
supplementation and against any alternative feeding methods other than
bottle.
He will not be her pediatrician, but I am sure he will be offering
suggestions for the infant's care.

I am trying to work out a recommendation for plan of care for her.
Ofcourse early initiation, frequent feedings and perhaps manual
expression of colostrum with spoon feeding, if infant is not too
interested are at the top of my list.  Also, close monitoring of diapers
and assessments of feedings.  (swallowing, breast softening,etc)

My question is when and how much pumping should I advise if infant is
sleepy or not too interested first 24 or 48 hrs?  If baby nurses fairly
well, should she still  do some pumping
after discharge and how much?   I do not have a lot of experience with
SNS use, so if number of diapers is adequate, would one  be needed?   I
really like to make things as easy as possible for moms after discharge,
but I also realize breastfeeding for this mom might be a challenge.

From our discussions, she has stated that she will be supplementing.
Our pediatricians are kind of resistant to alternate feeding methods, so
I am not even sure what the response will be to the SNS, much less any
other method.

I would be grateful for any additional suggestions.

TIA,
Judy Hatfield, IBCLC

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