Fellow lactnetters, Today, during a staff education class for
breastfeeding, several of the nursery staff had issue with the amount of
volume a newborn stomach can take. (I used the belly balls for visual
aide). We (the LCs) are trying to use the evidence to promote change in
practice for feeding or supplementing with large volumes over 15ml in
the first 24-48 hours.  One thing the staff said was that when a bottle
feeding baby is taking less than an ounce they do not consider this to
be a good feeder. And they said the pediatricians would feel the same.
They also brought up the fact that when a newborn has hypoglycemia our
policy states to feed the asymptomatic baby (either expressed breast
milk or formula) and our neonatologist orders 10cc/kg minimum. So many
of these babies, I would say almost all of these babies would get at
least an ounce more likely between 30 and 45ml.  They all felt that they
see infants tolerate this volume well.  I looked up the ABM protocol for
hypoglycemia and while it does say 3-5ml/kg it also says "up to 10ml/kg"


So my question is regarding the infant's stomach elasticity, if their
stomach is not able to stretch to accommodate more than a marble sized
amount then why are we able to give this volume. And if we feed more
than can be fit into their stomach and they don't throw it up, what is
happening to that volume that didn't fit into the stomach, their
stomachs aren't exploding open... What's going on?  Even if there is
good elasticity from the beginning how much can a chick pea sized tummy
stretch to?  

 

 

As a result of this morning's class, I am reviewing our hypoglycemia
policy. I am concerned though that some staff will walk away from
today's class thinking that the information I shared is not accurate
based on the amounts that they commonly feed infants that are tolerated,
(by tolerated, I mean that the infant doesn't throw up or become ill)


 

Thank you for sharing your wisdom. 

 

Pam Price IBCLC, RLC

Trident Medical Center

Charleston, SC USA

(843) 824-5013

 

 


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