An OB question

Do you mean for the mom? Because as far as I know babies, especially newborns shouldn't have water due to risk of fluid overload. Babies shouldn't have anything but breastmilk.

I agree. The question is vague and states "Rationale for first feeding being water". I've been reading the text for the past hour and found nothing of the sort, although I did find information confirming your claim on breastmilk. I'm stumped

Yeah more info needed.. And if it is mom? I didn't do my OB rotation, my assumption would to make sure she tolerates it as you can get sick to stomach during/after birth however after my lady partsl they didn't actually tell me I had to have water first.. My section of course was a slow diet progression as with any abdominal surgery!

I agree. The question is vague and states "Rationale for first feeding being water". I've been reading the text for the past hour and found nothing of the sort, although I did find information confirming your claim on breastmilk. I'm stumped

Oh ok, I thought you were just asking. I didn't know that's actually in your book. Hmmm...weird. I also start my OB rotation next week and there's a few things I don't like about the book. Anyway, I'm not sure...it sounds more like they're talking about a postpartum c-section mom....not a newborn. I'm stumped too....I wouldn't feel confortable giving a newborn water.

The neonates first meal is the mamas teet. Bonding is extremely important early on plus colostrum is very important.

The mother gets water.

The mother basically just had surgery, even if it was a vag birth it is still traumatic. You do not want anything solid running through her until you are 100% sure she has #1 bowel sounds, and #2 can tolerate food. Last thing you want is mother tossing her cookies into the babies face, or aspirating.

EDIT: If this question does refer to the baby recieving water as a first meal then tell them this is 2010, this isn't 1945 where Docs encouraged mothers to smoke to relax the mother and child...

I have never heard or or seen giving little guys water as a first meal...can't even think of a rationale for doing so... so glad I am not in school anymore...

There is absolutely no good reason to keep a hungry postpartum mom from eating after a normal lady partsl delivery. Some of our docs will even order diet as tolerated immediately after a c/section, though most will be on clear liquids (NOT just water) for at least 12 hours afterward.

We used to feed bottle-fed babies (NOT breast babies) their first feeding as water to r/o esophageal atresia/TEF, but not anymore.

There is ABSOLUTELY a good reason post c-section moms can't eat after birth until they pass gas. It's major abdominal surgery where peristalsis is often halted. Why would you put solid food through a duct when you don't even know if it's working???? I'm shocked your saying you work for a doctor who immediately puts them on diet as tolerated. How do you even know her bowels are working again after the anesthesia?!?!

After my 1st c-section I was allowed a regular diet....but I was mainly thirsty so I mainly drank anyway. After my 2nd c-section (different hospital), I was only allowed clear liquids. I was bad though, I snuck the food I brought. So I guess it just depends on the hospitals policy.

To the OP, the practice of feeding a newborn infant water as its first feeding is old and outdated. It goes back to the '50s and '60s when most lady partsl deliveries involved some sort of anesthesia and/or conscious sedation, causing respiratory and neuro depression in the infant at birth.

It was thought to be unsafe to feed these infants (who were almost all bottle-fed) formula for the first 12 or so hours of life due to the risk of aspiration. (Makes me wonder what the babies' blood sugars must have been, but they weren't checked back in those days.)

By the '70s and '80s, the use of heavy duty anesthesia for lady partsl deliveries had gone by the wayside, babies were more responsive at birth and more mothers were breastfeeding, so the practice of limiting early feedings to water went away as well.

Some doctors and hospitals stuck with the practice of offering a few sips of sterile water first, as Elvish stated, to rule out anatomic abnormalities such as TE fistula, but that practice has also faded. The incidence of TE fistula is very rare, and it is not necessarily associated with poor feeding. I once cared for a baby with a TE fistula who was 2 or 3 days old before it became apparent he had a problem.

Your handout contain some very old and outdated information. I think that would make for an interesting class discussion.