Hi 
I have no opinion on formula vs glucose water. I wonder whether we do not 
need a shift in thinking  regarding supplementation. 
Generally I think most people agree that the baby does not need much in
 terms of nutrition in the first hours, but the problem is usually that if the baby does
 not settle down,  the mother feels overwhelmed because she doesn't know what to
 do and out comes the bottle and the supplement and it works everytime. 
One of the reasons are that the baby sucks.  
My thinking is that the baby needs sucking as much as he needs the drops of colostrum
 in the early hours. Sucking is familiar to the baby and it is reflexive and he has been using
 it to regulate his state for some time before birth, i.e. going from awake, to dozy, to sleeping etc. 
 A crying, highly alert baby is not in a feeding or settling mode, but sucking can help to settle him 
into a more quiet alert or dozy state so that he can feed or sleep.  
Frequently, in our setting,  if a baby will not go to the breast, colostrum is squirted into his mouth and then he is 
supposed to settle because he should not be hungry any longer. We associate not settling with hunger, 
and big baby's are very hungry so often need routine supplementation.
I have seen some success with initiating sucking in the unsettled baby and delivering the colostrum in drops 
while the baby is sucking, in that way extending the sucking time, isn't that what happens at the breast,
 lots of sucking - small amounts of colostrum. The sucking gets many systems going, the baby can relax,
 calm down, feel good (vagal stimulation - all the kangaroo mother care stuff-) and then the feeding reflexes
 can emerge.  
Skin to skin is a pre-requisite, but if that does not calm the baby and he is not settled sufficiently to latch
 onto the breast then sucking can be initiated e.g. on the mother's finger and someone can deliver the drops
 of colostrum (dads can be good at this). 
So perhaps it is possible to take the emphasis off the supplementation as food by getting people to focus on
how they can support the mother and baby so the baby can get to a state that will support feeding. 

Loraine Hamm
Speech Language Therapist/IBCLC
New Zealand

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