Sleepy Time

Babies tend to be alert and awake for about 2 hours after birth and then go into a sleepy state that lasts 24-36 hours. If the baby got a good nursing done in the first hour after birth, you don't have to be too concerned for at least 4 hours. If you're concerned, check a blood sugar. If the blood sugar stays good, I've let babies go 6 hours. I try to get them to nurse before that, but if they're sleepy, and have good sugars, and no other symptoms, and I've put them skin to skin with the mom and they still won't nurse, I'll let it go.

I don't get worried about a baby that won't nurse, at least not for the first 24 hours. Obviously, I make an effort to get baby interested - a few drops of expressed colostrum on Mom's nipple, skin-to-skin, that sort of thing. I generally set my goals low....all I want in the first 24 hours is for baby to figure out how to get a good latch. If that happens, I am not worried, as the rest will eventually come.

Some kids are born with a tummy full of mucus/amniotic fluid and so feel full. If baby is spitty or gags at the breast in the first 24 hours, this is often the case and I reassure parents that this is a very temporary thing.

The baby needs to have about one good feed in the first 24 hours. This is evidence-based and also the recommendentation of La Lech League. Remember that in years past, hospitals would actually keep babies NPO except for glucose water for 24 hours after birth (apparently in case there was an intestinal issue?? Crazy!). Now people seem to freak out after 4 -5 hours and want to force feed a baby. Amazing how the tables have turned!

I remember keeping all babies NPO for 8 hours after birth and they all, even breast fed babies, had to have sips of water before the first feed. The purpose was to check for esophogeal atresia. NPO for 8 hours, riding home from the hospital in the front seat in Mom's arms, put down to sleep on their stomach so they wouldn't gag and die if they reguritated--it's a wonder any lived to be reproducing now!!