An OB question

[Guerilla04]

Starting my OB rotation on Wednesday and am trying to finish a bunch of handout's for orientation tomorrow. Can anyone explain to me (briefly of course) the rationale for the first feeding being water? Thanks in advance!

[Jolie, BSN]

To the OP, the practice of feeding a newborn infant water as its first feeding is old and outdated.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Your handout contain some very old and outdated information.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.