I know that especially in our culture today breastfeeding is the absolute it thing to do, but sometimes it is not best for the baby, or not done correctly (ex. outside admissions for hyperbili, baby is dehydarated and tada..exclusively breastfeed; we give them the first bottle and they chug it down!). My questions are:
1. What are your thoughts on nipple confusion?
2. Is there a corellation between breast milk and jaundice really?
3. How do you thaw and/do you refridge refreeze milk?
4. using a pacifier?
Of course, in the NICU it's a little different because we have to put the baby's health first, and once it's explained (in an ideal world you could breastfeed your child, but he/she is in the NICU, this is not ideal!) parents are usually better about it. I have noticed that if a baby will BF he will, and if he won't, he needs a little more support, regardless of the bottle feeding.
We thaw out frozen milk, but we put the rest in the fridge.
We do give children pacifiers if they are not eating and need a soothing mechanism.Thoughts? t.
I'd also like to add that when it is doable we absolutely try to help both mom and baby with the process, including setting them up with a lactation consultant. The benefits of breastfeeding cannot be denied, and it's wonderful when it works.
NoCrumping, I'm not talking about NICU babies being starved. Obvioulsy my other posts dealt with that, maybe you didn't read them. There is a difference between breast FEEDING and a baby sucking at the breast getting nothing.
I didn't say breastfeeding wasn't work, it's work for the baby and takes time to learn. I just don't think it's a lot harder physically for them than bottlefeeding once they know how. They still have to work to get the formula/EBM from our bottles and deal with the flow. I'm not talking about sticking a 32 weeker on the breast and saying "OK, that's it, no formula supplementation, breast is best". I'm not a looney:) I'm talking about a nearly term or term baby who is big enough to latch properly onto a mother who has adequate milk supply. For them, I don't see why it would be so much more difficult to get milk from the breast.
NoCrumping - I agree with your post in relation to breastfeeding being harder than bottle feeding for the baby but hon, you don't want to come to my house when my 3 1/2 year old asks for "mommy milk". :chuckle
As our wonderful prmenrs says breastfeeding is a controversial subject and we've all done well so far.
If a woman is an IBCLC, Internationally Board Certified Lactation Consultant, the only control there really is over lactation professionals, she should never treat a patient so poorly and not give them additional information and should be reported to the board for her behavior.
Breastfeeding moms should watch closely for output, as it is a good indication of input. A rule of thumb is there should be the same number of voids as they are days old for the first few days. Once you reach day five I believe, they should be having 6-10 wet diapers, and variable amounts of poop. Full-term babies are not intended to have a large amount of food those first few days, they're built in with the supplies and capabilty to survive on colostrum for a week or two.
The miracle babies of the Mexican earthquake in 1985 is a wonderful example of that. A terrible earthquake shook the country, bringing many buildings, including hospitals, to the ground. 8-10 days after the quake, they found the newborn nursery, buried in the rubble, many of the babies still alive. They were brought out and nearly all of them survived. As the doctors explained it, babies are mostly water when they're born and they use those stores greatly. It's a truly amazing story and must have been such a joy and relief to their families that they could survive that long. It's amazing how the human body is so complex.
Of course, things are definitely different in preterm babies, even just slightly preterm, but the moms should be given guidance on what to look for as good nursing, what output should be, and if good nursing wasn't happening, what should they do to make sure that the baby is getting nourishment. And it isn't always just a bottle of formula or expressed breastmilk. It could be finger-feeding, cup feeding or a lactation aid. I know with my son, I didn't know what good nursing really was until he started doing it.
Our society right now, despite claims to the otherwise, is not really pro-breastfeeding. Most people give BFing lip service, but they discourage women from nursing in subtle and not-so-subtle ways. It makes it even more difficult for moms to learn how to nurse when they never see anyone else doing it. Plus, while people know "breast is best", there's a lot of things we know are "best", but we don't bother doing. Getting exercise 3 days a week, eating only organic food, getting 8-10 hours of sleep and living a stress free life are all best, but our society is a great supporter of "ehhh, it's good enough." When, especially with breastmilk, it might not be. (again, especially in the case of NICU babies and the risk of E. sakazakii contamination) There are a lot of components in breastmilk that cannot be replaced and duplicated. They aren't even sure what all is in breastmilk yet exactly - it changes constantly to suit the child's needs. Formula is certainly not evil, and it is definitely needed in some cases, but especially with preemies, breastmilk is very important to their health, helping to pass on some of the passive immunities that the infants did not receive during gestation and supplementing their weaker immune system. Again, I'll reiterate that of course there are exceptions, of course there are very valid and very good reasons to not nurse or pump. But nurses should be encouraging and offering help whenever possible, pointing moms to good resources and keeping them involved in their child's care.
And it is NORMAL and NATURAL to nurse a child between 2-5 years. It's what we were designed to do as human beings. What is common sense to you, and a lot of other people, is misinformation to those who have done the research and have read the information.
One of my worst pedi admissions was a 6 week old who had never learned to breast feed. He was being fed with a dropper. A neighbor of the mother was so worried about this tiny baby, that she and her hb went to talk to the parents, and she went with the mom to the doctor the next day. I was handed a blanket that felt empty, the baby was scrawny and weighed less than his 6 lb birthweight. We couldn't get an IV in him, he was transferred to Children's Hosp without one, and given a jugular line there.
This mother could not see there was a problem. She was having troubles breast feeding but did not want to give him formula, or a bottle. She almost had a dead baby.
And it is NORMAL and NATURAL to nurse a child between 2-5 years. It's what we were designed to do as human beings. What is common sense to you, and a lot of other people, is misinformation to those who have done the research and have read the information.
Just an FYI, the part of my post that referred to "common sense" , was not about "extended " breastfeeding, it was about formula being a tabu, with detriment to an infant who is *not* adequately breastfeeding. And just because it is deemed safe and natural to nurse a child well into the 5th year, that doesnt mean it is accepted by everyone......"research" has nothing to do with that.....And, we were "designed" as human beings to do that, when we had no other means..... A 3-5 year old child has the means to nourish/comfort themselves. A woman can keep her milk supply for as many years as she is nursing... do you recommend the child nurses well into adulthood? There should be a certain time to seriously consider weaning, and I think it should be *WELL* before the 4th year!!!!! This has NOTHING to do with any research you may quote. And I am well aware of the Laleche League's position. No hard feelings, honestly. As irritated as you are to hear my comments, I am just as "irritated" to hear that a child at 3,4,5 yrs old is still breastfeeding. To me, there is a lot that is wrong with that ideology. Social/sexual stigma regardless, we live in a time where these things *are* relevant to our everyday life. And, by the way, I am pro breastfeeding, but I think it should be a primary source of nutrition for an infant. Not for an actual CHILD. We could go round and round for days on this, but my firm opinion, is this: BREASTFEEDING A CHILD INTO THEIR 5TH YEAR, IS TURNING SOMETHING (breastfeeding) THAT IS HEALTHY, NATURAL AND BEAUTIFUL, INTO SOMETHING STRANGE..........
NoCrumping - I agree with your post in relation to breastfeeding being harder than bottle feeding for the baby but hon, you don't want to come to my house when my 3 1/2 year old asks for "mommy milk". :chuckle
As our wonderful prmenrs says breastfeeding is a controversial subject and we've all done well so far.
steph
TOUCHE', STEPH...... YA GOT ME THERE.....:sofahider
No, mimi, there's not a lot of volume when the baby is born, but the colostrum is packed with good stuff and babies don't need a lot of volume at that point. They nurse constantly after birth to stimulate mom's milk to come in.
They do nurse constantly after birth, but some babies do get hungry, no matter how much they nurse. So hungry they get a bellyache from it. Actually from being hungry and screaming, as the stomach gets full of air. And believe me, we do encourage the moms to come in very frequently. One teaspoonful of colostrum is one good suck, maybe two.
That's because lactation consultants will tell you ANYTHING to get you to breastfeed. Some of these moms are so pressured, that they go home and nearly starve their babies to death because they were waiting for their milk to "come in", etc... (it never does, because they dont feed enough, etc, whatever) and they were told to NOT supplement with formula, EVER. They seem to drive this point home real well, but always seem to fall short on actually breastfeeding, like whether the infant is ACTUALLY getting milk.Meanwhile, the bili is through the roof, the kid is dehydrated, miserable, and exposed to multitude of organisms in a NICU, instead of being at home, maybe taking a *gasp*.... BOTTLE here and there of *gasp* FORMULA or ...even expressed br milk, for petes sake. And for the record, it is alot of work to breastfeed. It is a natural way of feeding a child, and I agree it is best, who doesnt, but it is HARD WORK for a baby to learn.. it doesnt come naturally, its a learned behavior. If you put a preemie nipple in a baby's mouth, its there for them, the whole thing, right there, thats by default an easier way to feed, wouldnt you agree? No latch problems, etc... just suck, and milk comes out, NO? Now, if there is a weak suck in any circumstance, that is another issue, with both types of feeding. W e all get the BREAST IS BEST thing. But in a NICU setting, there are LOTS of things to consider. Do I have links on this giving you hard and fast research? NO, I didnt bother to . But I think *MOST* nicu nurses will agree this is COMMON SENSE.
As far as the extended breastfeeding, like til 3.5, even 5 yrs old, as I read in one post.....well, there is no politically correct way of saying what I think THAT is. So I wont say it. But I can say I agree with what someone said, that you can probly find a study showing benefits of bfing til a kid graduates high school, that doesnt mean its NORMAL. And touting intelligence, skills, etc for a kid who breastfed til he was 5 is just asenine, the same can be said for a baby who breast fed till he was 3 months, 6 months, a year old. You can blame "modern sexual views of breastfeeding " all you want, but to me, a CHILD who walks up to his mothers breast at the age, of lets say 3, is NOT NORMAL, in my opinion. To be honest, it makes me shudder. I breastfed my own two INFANTS. I stopped at 1 year. I am not saying this is THE correct thing, and everybody should stop at 1 yr. But, to me, the idea of a walking, talking CHILD suckling on my breast did NOT seem "NATURAL" TO ME. Again, sorry to offend those of you that do that. I just cant imagine it..... being acceptable to some people..... come on, 3-5 year olds??????????????????????????????????
I agree with you completely. No matter what anyone says on this topic, the idea of older children breastfeeding is very disgusting to me. It passes the point of being a normal, natural thing, to being unhealthy IMO. You won't see any experts on childcare advocating feeding a child with a bottle at those ages, not so much as a bottle of water. So some of you saying that BF is okay for a 3 year old, but would you say a bottle fed child should continue to that age?
I just think that the docs and mgmnt should convey to the parents that while this is still their child, the NICU , is still an INTENSIVE CARE setting, and for the most part, YOUR PREFERENCES AND "CHOICES" should take a back seat to the expertise and knowledge and (clinical evidence )of those caring for the PATIENT. (who, yes, happens to be your baby) Does anybody else see my point?
Absolutely. YOU are the professionals, the baby was placed in your care, therefor, YOU should make those decisions, not the parents. On the other hand, they are the parents, so any choices that can safely be made by them, should be deferred to them. They are in a difficult situation and may feel more in control if they get to make some decisions regarding the baby's care. But those decisions should be the type that could not cause the baby any distress no matter what they choose.
You seem to think it is just LLL who thinks that nursing should be past a year, but it isn't. It's common in countries other than US/Canada/UK/Oz, mainly because we're the ones who have the weird sexual hangups.
The World Health Organization recommends breastfeeding for AT LEAST 2 years. American Association of Family Practitioners recommends breastfeeding for AT LEAST 2 years. CDC also recommends AT LEAST 2 years. AAP is still behind the times at says AT LEAST one year, as well as other groups, but all of them qualify that it should continue as long as mother and child are both amenable.
Actually, from the breast, the colostrum comes out slower than it would a bottle and it's constantly being replaced. Crying is a late indicator of hunger in a full-term infant and many mothers mistakenly wait for the baby to cry/fuss before feeding them, which leads to the swallowing of air, continued screaming and a bad cycle of unhappiness. Again, this is for full-term infants; obviously, things are different in preterm infants and the unique challenges facing moms and nurses for preterm infants.
I totallly agree with nocrumping 1-2 years is long enough in my opinion to breastfeed. Earlier when i wrote breast is best some said it isnt always best because of preterm babies drugs etc.. i thought the question was general not about breastfeeding neonate's or drug abusers.
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And it is NORMAL and NATURAL to nurse a child between 2-5 years. It's what we were designed to do as human beings. What is common sense to you, and a lot of other people, is misinformation to those who have done the research and have read the information.
Just an FYI, the part of my post that referred to "common sense" , was not about "extended " breastfeeding, it was about formula being a tabu, with detriment to an infant who is *not* adequately breastfeeding. And just because it is deemed safe and natural to nurse a child well into the 5th year, that doesnt mean it is accepted by everyone......"research" has nothing to do with that.....And, we were "designed" as human beings to do that, when we had no other means..... A 3-5 year old child has the means to nourish/comfort themselves. A woman can keep her milk supply for as many years as she is nursing... do you recommend the child nurses well into adulthood? There should be a certain time to seriously consider weaning, and I think it should be *WELL* before the 4th year!!!!! This has NOTHING to do with any research you may quote. And I am well aware of the Laleche League's position. No hard feelings, honestly. As irritated as you are to hear my comments, I am just as "irritated" to hear that a child at 3,4,5 yrs old is still breastfeeding. To me, there is a lot that is wrong with that ideology. Social/sexual stigma regardless, we live in a time where these things *are* relevant to our everyday life. And, by the way, I am pro breastfeeding, but I think it should be a primary source of nutrition for an infant. Not for an actual CHILD. We could go round and round for days on this, but my firm opinion, is this: BREASTFEEDING A CHILD INTO THEIR 5TH YEAR, IS TURNING SOMETHING (breastfeeding) THAT IS HEALTHY, NATURAL AND BEAUTIFUL, INTO SOMETHING STRANGE..........
I nursed my daughter till she was almost two and my son tillhe was 3 and a half, he called it "ish, ish". A mother doesn't necesarily plan how long she is going to nurse the child but as long as both parties are in agreement I don't think this is a problem. Nursing a toddler extends farther thatn just nurishment. Here is an interesting article supporting breastfeeding the toddler. http://www.kellymom.com/newman/bf_toddler_01-03.html
As irritated as you are to hear my comments, I am just as "irritated" to hear that a child at 3,4,5 yrs old is still breastfeeding. To me, there is a lot that is wrong with that ideology. Social/sexual stigma regardless, we live in a time where these things *are* relevant to our everyday life. And, by the way, I am pro breastfeeding, but I think it should be a primary source of nutrition for an infant. Not for an actual CHILD. We could go round and round for days on this, but my firm opinion, is this: BREASTFEEDING A CHILD INTO THEIR 5TH YEAR, IS TURNING SOMETHING (breastfeeding) THAT IS HEALTHY, NATURAL AND BEAUTIFUL, INTO SOMETHING STRANGE..........
YA GOT ME THERE.....:sofahider
fergus51
6,620 Posts
NoCrumping, I'm not talking about NICU babies being starved. Obvioulsy my other posts dealt with that, maybe you didn't read them. There is a difference between breast FEEDING and a baby sucking at the breast getting nothing.
I didn't say breastfeeding wasn't work, it's work for the baby and takes time to learn. I just don't think it's a lot harder physically for them than bottlefeeding once they know how. They still have to work to get the formula/EBM from our bottles and deal with the flow. I'm not talking about sticking a 32 weeker on the breast and saying "OK, that's it, no formula supplementation, breast is best". I'm not a looney:) I'm talking about a nearly term or term baby who is big enough to latch properly onto a mother who has adequate milk supply. For them, I don't see why it would be so much more difficult to get milk from the breast.