[Jolie]

OK, I've been out of it for awhile, but I thought that the pink nipples were made by Enfamil. Anyway, I liked them a whole lot better than the red ones.

Dawngloves, how in the world do you get insurance companies to pay for stays up to 1800 grams? We had to do away with that criteria years ago because insurance companies refused to accept it as a justification for keeping a baby in the hospital. We used to wean babies to open cribs first, then concentrate on moving to all po feeds. We had to reverse the process, because we actually had one case manager tell us that she could easily send a baby home on ng feeds, but sending one home in an isolette was a "little tougher".

[dawngloves]

[quote=Jolie]

Dawngloves, how in the world do you get insurance companies to pay for stays up to 1800 grams? We had to do away with that criteria years ago because insurance companies refused to accept it as a justification for keeping a baby in the hospital.QUOTE]
Really?? Even if the kid is 1900g and loses weight for two days in a row, we keep them in until they gain weight for two days!It's never really been an issue because by the time we get them to PO all their feeds they are about 1800. And with a term nipple no less!
We don't wean until they are 1600g and won't try PO until they are 34ish weeks gestation.

[Mimi2RN]

We use the red nipples on premies and bigger kids who have been poor feeders. Sometimes the NUKs work, but I've had them collapse and give the baby a milk bath. If necessary, we give the mom some red nipples to take home with the baby.

Gompers, I remember being handed a baby, wrapped in a blanket, that was so light it felt empty. He was 6 weeks old, less than birthweight.......his mom had been feeding him with an eye dropper, because he wouldn't breast feed. Mom couldn't see he was being starved to death. It took a very pushy neighbour to insist that mom take him in to see the ped. Mom and dad already had a 2 year old, and had no problems with that child.

[Gompers]

Originally Posted by Mimi2RN

Gompers, I remember being handed a baby, wrapped in a blanket, that was so light it felt empty.

Just wondering why this was directed at me! Not that it was a negative comment or anything - I totally agree that sometimes breastfeeding moms don't see that their baby is starving to death! Those are the ones we get from the ER, a week old, severely dehydrated, with bilirubin levels of 29!

[nekhismom]

We don't have preemie nipples, either. It's all regular "term" sized nipples. I think our MD's and NNPs push the kids to PO feed so early, we have like 25 and 26 weekers who po feed at least once a day, sometimes more. Those kids are slugs! But they must attempt PO qd. And they spill more than they take. Preemie nipples would be great!

[Gompers]

Originally Posted by nekhismom

We don't have preemie nipples, either. It's all regular "term" sized nipples. I think our MD's and NNPs push the kids to PO feed so early, we have like 25 and 26 weekers who po feed at least once a day, sometimes more. Those kids are slugs! But they must attempt PO qd. And they spill more than they take. Preemie nipples would be great!

I'm hoping you mean FORMER 25 and 26 weekers PO feeding!

Our docs and NNPs order PO transition at 32 weeks if the baby's respiratory status is stable. But it is ultimately up to the nurse whether she wants to PO feed or not. The docs or NNPs can complain, but we go as slow as the babies need.

[Gompers]

Originally Posted by dawngloves

Gompers, you are one lucky RN to have someone mix your formulas!Drives me crazy when I have to make Neosure 29 or something crazy!
If we have a kid that was leaking like that we'd squeeze his cheeks and chin together for "support".
Can't remember the last time I used those pink nipples. Maybe for some IUGR kiddo.Remind me of when I fed baby rabbits!

I know, we are spoiled ROTTEN!!! We have nutritionalists who make up formula and breastmilk mixtures every day in syringes or jugs (for the bigger kids) all nice and neat, daily supply in the fridge by 4pm sharp. Each kiddo has his or her own labeled stash! Otherwise we use plain breastmilk or the regular pre-made bottled formula.

I do try to give chin and cheek support, but the trouble I always run into there is that then the baby has an even better suck and gets MORE milk into his/her mouth...but that doesn't change that fact that the kid doesn't understand the concept of swallowing! Hence the mouthful of formula spilled onto the bib.

[dawngloves]

PO feed a 29 weeker???!! I would put my head through a wall! Don't you just feel like screaming "Eat!!! EEEAAAAT!!!" Some days?

[Mimi2RN]

Sorry, Gompers, I directed it to the wrong person.
It was fergus who wrote about breastfeeding (nipple confused) moms who choose to cup and/or finger feed their babies at home.

Hi fergus!

[fergus51]

HI!

Seriously, you wouldn't believe how many breastfeeding dehydrated babies we get who wind up needing triple photo. I actually prefer the cup feeding cause at least those moms can measure some of the feeds. I honestly don't know what some of our postpartum nurses are teaching moms, cause it is always the term kids we get like this.