Hi all,
I have a question about what seems to make the most sense in the following
situation.

I did anesthesia for a cesarean delivery this week, and after baby was
initially resuscitated (breech, with LONG uterine incision-to-delivery time)
dad and I were able to help mom hold baby skin-to-skin during the closure.
Baby didn't attempt to latch for the 20 min or so that he lay with the
nipple right in front of him, so we figured when we got back to mom's room
she could get more comfortable and he could take all the time he needed.
However, we then noticed that he seemed to be in mild respiratory distress
so he was taken to the nursery after we got out of the OR.  Presumably for
several hours of observation, but it was impossible to predict how long it
would be before he could try nursing again -- 3 hrs, 6 hrs, 12hrs?

At what point should mom express colostrum when there's an initial delay in
baby being able to nurse?  Or should she just wait the first few hours so
that there would be a nice bolus available for baby when he could first
try?  That's what I was told the last time we ran into this same scenario,
but then the couple predicted hours stretched into many many hours and mom
could have expressed and stimulated her breasts a couple of times in the
interim.  Trying to figure out what makes the most sense to argue for,
especially in our decidedly baby-UNfriendly hospital.

Thanks for any ideas,
-Sarah Reece-Stremtan M.D. (anesthesiology resident, but often seemingly the
sole mom-baby advocate on the labor/delivery floor)

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