I was very interested in this, Marley, as the medical practice you outline
is different here in the UK.

Firstly, this baby would not be suctioned at birth. Secondly, there would
be no testing of blood sugar (and this baby had several blodd sugars
done...)

The suctioning  alone, I think, (and see previous posts on Lactnet) can
contribute to a lack of desire on the baby's part to suck. The repeated
tests for blood sugar is invasive, and in any case, we know the info
obtained is (often) at best useless and at worst misleading in asymptomatic
babies.

>12 hours - Large amounts x2 of mucous with old blood spit up.  No void. Pedi
>initiated a call, concerned LGA and lack of fluid/nourishment.

The baby had voided before -  UK paeds and midwives would not regard no
further void at 12 hours as a red flag. Neither glucose or formula would be
suggested at this stage, but by now, ideally, the mum would be expressing
colustrum direct into a cup.  Gastric suction would not be done either.

>30cc 5% glucose given by cup.

That is a *lot* of fluid for a baby 12 hours old.

>28 hours - report received.  Total of 50cc/12hr  formula via nipple.

Ditto volume -  bottle feeding means volume is often excessive and
unphysiological, and what a shame it was formula.....

Nipple shield tried, report of minimal effort
>from babe.

Too soon, IMHO, for the shield.  Why no skin to skin and bedding in?
Mothers cannot respond to babies' cues if the babies are separated, either
in a nursery (horrors) or in a plastic box next to the bed.

>
>  50 cc formula (pedi order) via cup.

Ditto volume.

> Mom set up with
>electric pump.  20 cc colostrum obtained.

Yes, we'd do this, though on day 2 hand expressing might be preferable to
electric pump, as you 'catch' more - drops don't get stuck to pump parts.
>

>Did the baby wake up on his own or did the colostrum have something to do
>with it?

Who knows? It is physiologocal for the new baby to have colostrum, and this
helps wake the bany up anyway.

>  Perhaps I can convince other staff -
>including pedi - that pumping and cup feeding is more beneficial than
>nipples and formula!!
>
Yeah!  And maybe hold the suctioning and blood sugar testing, too!  Replace
with skin to skin and bedding in!

I think babies in these situations get messed about, and turned off bf. We
see similar situations here, too, though there is hardly ever as much
testing as you have in the US.

Heather Welford Neil
NCT bfc Newcastle upon Tyne UK

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