baby not keen on breast and jiterry..what to do

[raynienatasha]

guys need help around here.... in my hospital where i practice when a baby is not keen in sucking on breast and the baby looks jittery we will supplement the baby with a dr order( its a standing oder actually if the glucometer level is below 3 mmol/L) although the mothers insist on total breastfeeding... what is your practice in your hospital... what irks me most is even though we explain to mother that your baby's glucometer is low and we need to supplement the baby for one time they still insist on total breastfeeding..And they keep on saying that they say its not harmful to total breastfeed your baby( because they read in in internet).....so what are you guys practicing in your hospital... Have you come across mothers who breastfeed baby on a limited time in night shift so that they can sleep although baby is still crying for milk..And when we say you have to breastfeed longer because your baby still looks hungry, they look unhappy...(like they are expecting us just to make the baby stop crying) .what do you say to these mothers ?? Your experience please?

[PAERRN20]

I'm not an OB nurse nor a mother, so take my advice with a grain of salt if you wish. My advice would be to educate the mother on s/s of hypoglycemia and the serious consquences that can result from low blood glucose, i.e. hypoglycemia coma. This is important especially when they take the infant home and decide not to breastfeed through the night. Would it be possible to have the woman pump some breast milk and bottle feed that?

[Quark09]

In that case I would have that baby at the breast every hour. Stimulate baby to eat; wake her up if necessary and bring her right to mom. If mom is wanting to breastfeed exclusively we will wake her to feed her baby; if she doesn't want to be bothered, then we are clear on our nutritive policy. I've come across this a few times, mom either steps up and feeds on demand/as needed or allows a bottle.

[RscodADN10]

Educate, Educate! New moms, at least I was, are a little timid, tired and everything is so new! The Internet can not take care of our children even though we wish! So take the time to tell them that to make more milk they need to bf on demand. And all the benefits of it and confort them when they are tired to keep on keeping on.That you understand that they are tired but that this new child needs it.

It's a scary, tiring time! Be patient with them!

[serenity1]

We offer to supplement with the sns, cup or spoon if mother is just opposed to a bottle/nipple. If she totally objects to formula and the baby has low blood glucose, the dr. will give the mother the option of formula or starting an IV on the baby. They usually choose the formula at that point. Some do choose to put the baby in the nicu for the iv.

[Doza]

I am not a pediatric nurse too. But I have had a similar experience with my son.

My son was not too keen on the breast feeding thing at the start and he was given a supplemental feeding. I tried several times but my son wouldn't latch. My nurse had me express my milk and put it in a small bottle with a small nipple which was supplied by the NICU. It totally worked. Breast milk in a bottle. A combi of both.

[GHGoonette, BSN, RN]

In that case I would have that baby at the breast every hour. Stimulate baby to eat; wake her up if necessary and bring her right to mom. If mom is wanting to breastfeed exclusively we will wake her to feed her baby; if she doesn't want to be bothered, then we are clear on our nutritive policy. I've come across this a few times, mom either steps up and feeds on demand/as needed or allows a bottle.

Excellent advice. I'm not in OB myself, but I can see the absolute logic of this response. Good one.:up:

[NamasteNurse, BSN, RN]

Not a Neonatal nurse, but an ex-breastfeeding mom and La Leche League Leader. Breastfeeding is a huge commitment of time. Many young people especially new moms who have never given themselves to another, do not get this. It is learned. They will be needing to sacrifice many times in the years to come and this is just a first. Do they really think they will be sleeping through the night with a new baby at home?

They need education and fast! Breastfeeding moms should be sleeping with their baby and feeding on demand. Artificial nipples will cause nipple confusion and make breastfeeding harder and possibly more uncomfortable as baby will have to learn to suck in two different ways.

Some babies do adapt, but some do not. Then they prefer the 'easy bottle' and mom thinks she's doing something wrong. It becomes a vicious circle. Babies who are breastfed exclusively and on demand rarely have any nutritional deficiencies.

[Quark09]

Excellent advice. I'm not in OB myself, but I can see the absolute logic of this response. Good one.:up:

Thank ya :)

To the OP - we've had many issues with moms coming in, armed with internet advice and brandishing their MD they got from Google University. Educating yourself is one thing; believing all the BS you read on the 'net is quite another. Our facility has a firm policy re birth contracts and the like; namely if you want to run the entire show yourself, you would best be served with a home birth or birthing center. We have incredible CNMs here who guide pts through relatively event-less births, but mothers understand that the monitoring and such are not, as some websites like to claim, for the convenience of the docs.

That said, as AP wrote, babies who are breastfed on demand and exclusively rarely have nutritional deficiencies. If mom is ready to belly up and eschew her sleep to breastfeed (rather than letting dad, et al help with that) then she needs to know it's on baby's schedule, not hers. I've woken a groggy mom who was adamant about BFing post c-sec; she wanted little one to have nothing but the breast... so baby ate with me right there assisting to hold :) We joked later that I "breastfed" her baby.

The big thing is - if mom really, really, wants to BF, help her in any way you can; advise rooming in, help her keep a nursing diary, show her how to stimulate a groggy baby and get her ready to eat. But know when to tell her there is absolutely nothing wrong with deciding to bottle feed - after the fact, I've heard all too often that what mom needed to hear was that it was okay if she didn't breastfeed (pressure from other friends, parents, relatives, etc). She's a good mother because she's ensuring her child is well-fed and happy, and that mom is happy too.

[klone, MSN, RN]

What drives me crazy is the moms who want exclusive breastfeeding, no nipples (no pacifiers) and then want to send baby to the nursery all night, with instructions only to be brought out every 3 hours to feed.

I don't mind watching your baby for you to get some sleep, but if you're not going to have that baby in the room with you so you can soothe it, at least allow US the tools to soothe your baby!

[2011NursingStudent]

I wanted to breastfeed my first son, but for whatever reason, in the hospital they took him away right away to do all their standard tests, and then brought him back to me announcing that they had fed him his first bottle. I was so sad and am still sad about that almost 8 years later. I really wanted to feed my baby the first time after he was born, and I felt like that was taken away from me. Not only that, from then on, he seemed to think milk came from that nipple, and whenever I would attempt to breastfeed, he would scream and not even try until I gave him that bottle with the artificial nipple. :/ My second son I knew enough to say beforehand that I was going to breastfeed and it worked out fine, but I really wish nurses would ask new moms before they just go giving them their first feeding out of a bottle. I was 20 at the time and I guess they just assumed because I was young, I wouldn't breastfeed or didn't care, or that they knew what was best.

[klone, MSN, RN]

I really wish nurses would ask new moms before they just go giving them their first feeding out of a bottle.

I'm sorry that happened to you.

Everywhere I've worked, the nurses wouldn't dare to give a bottle without first talking to/asking the MOC. I know that that does happen other places, because I've talked to enough people to whom that happened, but in my professional experience, I've never personally seen it. We also don't give pacifiers unless the parents say they're okay with them.