There should be no flames sent toward Kathy. I am actually in a very similar situation at my work place as you are. I just want to clarify some points for our LACTNET group. Slowly and with as much persistence we need to educate the people and parents we work with. We will have to give in to some pressure and keep within our scope of practice. That said I still feel we need to continue to point out evidence based information to all around us so over time they will know we are always coming from the same direction. Evidence: Babies in the first 24 hours only need colostrum, baby's feedings will have intermittent swallowing of amounts ranging from 7-14cc. Babies are recovering from birth, this can take up to 3 days. Mother's milk volume increases every day postpartum with the largest increase occurring 3-5 days PP. Babies have an extra layer of fluid on board at birth and can loss up to 7-10% in the first 3-4 days before starting to gain. Babies respond better when skin-to-skin, showing feeding cues and arouse better than when separated. Also maintain their temperatures and stabilize their blood sugars. Mothers sleep better when their babies are with them. The sooner and more frequently the breast are stimulated and milk is extracted, the faster that Lactogenisis II occurs. These are statements we can continue to repeat. Over time hopefully staff and parents will hear it and feel confident in it. In the mean time we make compromises. :-( The next step we can take and this is what we are working on at our hospital; are the 10 steps to Baby Friendly. Included in these steps is rooming-in. I think this is huge. What Kathy and Ester pointed out as problems with non-latching babies only worsens with mother/baby separation. Ester your comments about when to intervene with a non-latching baby. I don't think if they were left with their mothers for 24 hours using skin-to-skin that they would not make an effort to root. If they are rooting and not able to latch that is when I would have the mother expressing colostrum into the baby's mouth or on a spoon. This counts as intake/feeding. Someday I hope to see the majority of hospitals as Baby Friendly and this will because of all of you hanging in there fighting the good fight and sticking with evidence based information. Ann Perry, RN IBCLC Boston, MA *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html