Cholostrum/breastmilk as eye treatment

Mimi2RN, ASN, RN · May 5, 2004

I said 44 was borderline. 37 was low, and fell into our protocol. The intial BS did not which is when the nurse TOLD the father she was going to give it formula despite that it was a breast baby, and that she didn't ASK! These were accuchecks done on the floor.
Our protocol states if the BS is 20-40, the baby nurses if breastfeeding or is given formula if botte fed, then the BS is rechecked 1 HOUR later. This nurse checked it 20 min later. IMO, it was too early for the feed to make a change in the BS result. Less than 20, they get D10.

We HAVE to draw a blood glucose if we have a pcx 45 or less. At that point, if the baby looks good, I'll tell the parents what is going on, and let her breastfeed. I do suggest formula if the blood glucose doesn't look good. It takes about an hour to get the result back, just time to do the next pcx. If the glucose is higher than my original pcx, and the next one ok, the baby can go out with mom. We don't cup feed in the nursery. If the parents want it, that's up to them. I like to know if the baby can suck, and a baby that won't nipple may have something else going on.

I find feeding protocols very interesting....how much they differ. The one we were supposed to use had us sticking these poor babies every 20 minutes, that went over really well....I don't know where management finds some of these plans. You know that no-one who works with the babies has that kind of time, and the babies feet turn into mincemeat!

lgowan · May 11, 2004

Does your protocol include checking every baby, or just jittery, LGA, or SGA babies? There is no need to even check a sugar unless it is justified. In our unit, we will check if jittery, LGA, or SGA (according to Dubowitz). If below 40, we recheck a lab glucose. A sugar is done an hour later, and then 2 more times just before feedings. However, we are even rethinking our policy because the peds are complaining about the mincemeat heels and undue pain.

Lisa

The peds normally even give the breastfeeding baby 24-36 hours before they start panicking about low sugars. Especially c-section or nuchal babies, since they tend to be poorer feeders anyway even on the bottle.

SmilingBluEyes · May 11, 2004

If you read my post, you see not every newborn is checked---only those who are at risk or have symptoms. That is FAR from every newborn.

L&D_RN_OH · May 11, 2004

In our unit, we will check if jittery, LGA, or SGA (according to Dubowitz). If below 40, we recheck a lab glucose. A sugar is done an hour later, and then 2 more times just before feedings.

Same here, plus mec stained babies.

midwife sarah · May 16, 2004

Had a look on MIDIRS search engine to search for articles related to midwifery and I couldnt find any article re. use of breastmilk/colostrum for eye infections. In UK its seems to be commonly given advice and seems to work a treat.

SnowymtnRN · May 16, 2004

WOW. I tell you, i think i'd have to come down like a ton of bricks on that nurse. I don't understand nurses who feel like when a baby is born, the baby is THEIRS to dictate care to and how to manage things. She basically badgered and bullied these parents, and this takes away from their birth experience.

I'm thinking jumbled here. But for those who reply a bottle isn't the end of the world, one bottle won't hurt, etc...why is it that we feel as nurses the FIRST thing we have to do is stick a bottle in the babies mouth? I mean this mom should have been given the CHANCE to bf first, then recheck the sugar, and if still low then obviousely intervene. I am one of those mothers who refused formula unless it was medically necessary, and in the event of a feeding was needed it should be done via syringe/cup method ONLY and by me or my DH. This is this couple's child, not the hospitals, not the nurses and if there was no emminent danger WHY was this nurse so hell bent on doing things herself and her way? If i were that couple, i'd write everything up and report her to the unit manager and hospital board. Seriousely. Just because WE think as nurses one bottle or formula feeding won't hurt doesn't mean that's how the parents feel. And its not OUR baby to make those judgements. Obviousely if something were going wrong, was the baby symptomatic with a borderline BG, etc...then intervention was necessary. Honestly it sounds like this couple's plans for their birth experience (no matter how different, odd or unconventional it was) was ruined. And was it a big deal to hold off on the bath? my lord no. I mean its a BATH. It won't hurt to wait until the parents bonded, or maybe the parents wanted to do it!!!!!! What's the big deal??

I have 3 kids, and all 3 of my kids didn't get the eye ointment tx. I refused it because a. they were c/s babies

b. i had no diseases or infections

c. my DH and i are monogomous so the risk of STD's and transmission was NIL.

So why was it necessary? it wasn't. I've also used breastmilk on NUMEROUS occassions. For eyes to heal any ickies going on, to lubricate and for comfort with blocked tear ducts.....i used it on my second son's umbilical stump cuz it got wet and oozy and wasn't healing properly....my DH fell down had a HUGE scrape on his leg so i got some pumped milk after he tried to get it to heal for 2 weeks and it was VERY much infected...my breast milk healed it in 2 days. Completely NO scars or anything. Breast milk should be used for EVERYTHING! I gave some to my friend when her child (10 mths old i think) couldn't get rid of an ear infection. Breast milk healed it in about 3 days, COMPLETELY. I firmly believe use breast milk before ANYTHING!!!!! IT'll heal it!!

Seriousely, i'd tell that nurse to get OVER herself, she's bullying the patients!!!!!

L&D_RN_OH · May 17, 2004

If i were that couple, i'd write everything up and report her to the unit manager and hospital board.

I talked to one of the midwives the other day. They are writing it all up. I'm not sure who all they are sending it to though. I was glad to hear they are following up with it though. Change won't be made if no one believes there is a problem.