As a Lactation Consultant and a NICU nurse that is the standard to instruct
parents that feedings should not last longer than 30 min. I am under the
impression this refers more to babies who are not good Po feeders and
forcing" them to bottle feed just to say they took the whole thing when they
are not ready can stress them and then "burn more calories." I have no
literature to back this up but I have been in the NICU since 1991 and that
has been the standard. I, of course, let the breastfeeding go on longer
because I know most of the smaller babies 33-35 weekers just are slower,
takes more breaks so they are not feeding/transfering milk continuously.
Carolyn
Pittsburgh, Pa
-------Original Message-------
From: [log in to unmask]
Date: 8/14/2008 8:19:03 PM
To: [log in to unmask]
Subject: Re: NOT breastfeeding a preemie longer than 30 minutes due to loss
of calories??
April writes:
I'm working with a client who was told by NICU staff to not nurse her
preemie (born at 33 weeks) longer than 30 minutes or so because he'll loose
the
calories he is getting from breastfeeding. However, being a preemie, he
falls
asleep at the breast a lot and is happy to nurse while sleeping. I have
never,
ever heard that and checked all my resources and still can't find
anything.
~~ I wonder if they are saying that when they actually mean that spending
long periods of time (which they define at 30 minutes or more) at breast
may
be too stressful for a preemie who may have stamina issues, and may not be
strong enough to transfer adequate amounts of milk before fatiguing out,
and
then would end up underfed if they just fall asleep/shut down unsatiated. I
would also be careful of allowing a premature baby to expend energy, over a
period of time, on any form of feeding without seeing if there is any milk
transfer. Babies who come early can often have real issues with stamina, so
they may
want to cap breast time until they can be sure that the baby is working
efficiently enough. Although it is probably more important to actually look
at
the baby, not the clock, by assessing rhythmic swallowing, sucking bursts,
latch position, and test weights, etc., not all NICU nurses feel competent
or are
encouraged to do this, and NICUs are often about walking the line between
being patient with learning normal feedings skills, while keeping in mind
the
potential compromising things these babies often have to deal with and
developing general rules to deal with them. It would be important to make
sure that
this baby is actually "nursing while sleeping", meaning actually
transferring milk, or is he just hanging out, enjoying closeness, signaling
milk
production, all good and important things to be sure, but not actually
transferring
decent amounts of milk. Time at breast without significant milk transfer is
not bad, unless it means the baby is then too fatigued or disorganized to
feed
adequately after that. So, I think I know the concept they are trying to
get
at, they are just not wording it right, in my opinion.
Peace,
Judy
Judy LeVan Fram, PT, IBCLC, LLLL
Brooklyn, NY, USA
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