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Subject:
From:
Chris Betzold <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Mon, 3 Nov 2008 10:13:57 -0800
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Ideally infants will first be supplemented with expressed breastmilk.   
But if this is not available or minimally available during the first 3  
days of life then judicious glucose supplements are preferred.  If  
they can be mixed with some colostrum (even a few drops) even better.  
The reasons they are preferred are:

1. Allergic proteins are not introduced  thus allergic reactions,  
diabetes, asthma risks are lowered.
2. Glucose doesn't stay in the stomach long so, it minimizes the  
disruption of nursing frequency
3. During the first few days of life (unless the infant is jaundiced)  
hydration is more important than calories and some infants who were  
nursing poorly will nurse better after a little sugar water perks them  
up.

If possible she should still do some stimulation by hand expression,  
pumping or supplementing at the breast.

If the infant is jaundiced or a serious lack of maternal breastmilk is  
present then the next best would be banked milk.  This might be a  
stretch for your hospital but administration must start being taught   
that introduction of formula puts them at risk of lawsuit if the  
infant develops cow's milk allergy, colitis, asthma, diabetes, etc.

I am sure you can find documentation for all or most of this.  Look to  
the AAP policy statement and  the ABM protocols for starters.    Good  
luck,  Christine Betzold NP CLC MSN

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