Ezzo Parenting Debate

Hello all, I previously posted as <krsandberg>, but since have a new screen name. I have been lurking on and off, but have come across a situation and want to pose a question. My best friend had her baby last Sunday morning, and unfortunately the baby got pneumonia the day she was born and has had to go to the NICU. They are concerned about strep B pneumonia and have decided to keep the baby in the NICU for 10 days to receive antiboitics via IV. Therefore, the baby can not come out of the NICU until the 10 day. My friend BF her first child and defintitely wanted to with this one as well. The doctor and nurses said to feed every three hours. So, my friend was able to stay in the hospital the "normal" allotted (sp?) time fo 48 hours from delivery, all the while, going to the NICU and nursing every three hours. She is home now, baby still at the hospital, and she continues to drive over to the hospital at 8am, 11am, 2pm, 5pm, 8pm, 11pm to BF the baby. She is allowing them to give ther formula for the 2am and 5am feedings (She is too exhausted to go over in the middle of the night). The schedule was set by the doctors and nurses, not the mother.

The baby has done great, she is not supplemented between feedings and has done so well, that she has been able to come off IV fluids (they had her on strict IV's for 2 days following birth and the mommy pumped). So if the "3 hour schedule" is not "conducive to BFin"g as some say and it is "not good to schedule" at such a young age, why is it working so well and why would a team of professionals, at a nationally renowned hosptial recommend it if it could possible "endanger" the baby?

By the way, the mom asked the nurses in the NICU if the baby fusses much in between and they said no, not unless she has a poopy diaper. This mom never followed babywise per se, but did purchase and attend the GKGW class at our church. With her first (we had our babies three days apart) she was the one who demand fed more, and I was more of a scheduler. I think now she is realizing that scheduling a baby from the beginning is something that can and does work! Any thoughts?

Kelly

> why would a team of professionals, at a nationally renowned hosptial recommend it if it could possible "endanger" the baby?

Why would they reccommend from the start keeping the baby in the NICU for 10 days...without any knowledge of what condition the baby would be in in 5 days?

Because it is "routine." It is what they do, it is "easy" for them to prescribe. It is easy to tell a mother who needs to drive into the hospital to feed "if you just come in every 3 hrs, your baby will be fine. (Why not tell her to just camp out in the hospital all day, and perhaps even provide an overnight bed? Any mom I know who has breastfed a baby in NICU pretty much stays all day--night time accommodations depends on the hospital.) Pediatricians are NOTORIOUS for giving inaccurate breastfeeding advice. Many of their own children were not breastfed. In fact, formula companies will give pediatricians and obstetricians a year's supply of formula free when they have a baby--because they know that if the Dr. doesn't have a breastfed baby, they will not promote breastfeeding as strongly.

Some babies will do okay on a 3 hr routine. In some cases it does work. Especially for sick babies. Why? Because they are too tired to complain much.

But one needs to look at long term goals. If your friend is not pumping for those two missed feedings (and perhaps even another time since pumping does not stimulate milk production as well as nursing does), she is risking her milk supply at about 4 months. Actually, even if she is pumping those sessions, she may be compromising her milk supply. Will she *definitely* have milk supply problems? No. But she is playing Russian Roulette--she will not know if it is "okay" until it is too late to change.

BTW...if you want to see more examples of "nationally renowned medical centers" spewing mis-advice, you ought to get a copy of the May Clinic Guide to Baby's First Year (not sure of the exact title). Plenty of incorrect info in it--like that it is safe to forward face a child in a carseat at 6 months of age.

Jenn

My son also spent time in the NICU when he was born. He was also fed on a three hour schedule. Seems to me that when you have numerous babies in the NICU it would help the nurses to know what time to feed the baby, not have to watch baby's cues. Is baby on any IV's besides the antibiotics? That may make baby feel a little fuller. My son seemed to do alright on the three hour schedule as well. Though he was on IV's for quite a while so that may have contributed. One of the criteria that they had for him to be discharged was to not only wean him off the IV's but also to make sure that he could cue for food. The last night he was there he was fed on demand. I was fortunate in that I could room in at the hospital the entire time, all I had to do was ride an elevator. I also pumped and fed him via bottle. Every 2.5 hrs or so I'd get up, pump, clean, go down to the NICU, feed Connor and put him back to sleep, go upstairs and repeat. It wasn't fun but it was doable. I agree that she needs to be pumping the feedings that she's missing if she wants to help bring her milk in and keep it in. In my case I ended up with a lot of oversupply, which is a pain but much better to deal with than undersupply. Has she spoken with or is working with a certified LC, she'll be much more knowledgable about bfing than your average dr? What does the LC have to say about the schedule? Also, one thing she's going to want to watch out for is thrush. Connor ended up with thrush and we battled it on and off for almost a year. Another thing to watch for is nipple confusion or preference. I ended up using a nipple shield for 5 months in order to help us deal with that. Luckily I had a very fast letdown so he got the milk about as fast from me as he did from the bottle. Here are some links for more info on thrush, nipple confusion, weaning off supplements and pumping to maintain supply if you or any lurkers are interested.

Pumping and maintaining milk when baby isn't nursing
http://www.kellymom.com/bf/supply/maintainsupply-pump.html

Weaning from formula supplements
http://www.kellymom.com/bf/supply/decrease-formula.html

Nipple confusion
http://www.breastfeeding.com/all_about/all_about_confusion.html

Thrush
http://www.kellymom.com/bf/concerns/thrush/thrush-resources.html

<Why would they reccommend from the start keeping the baby in the NICU for 10 days...without any knowledge of what condition the baby would be in in 5 days?

Because it is "routine." It is what they do, it is "easy" for them to prescribe.>

I think they hardly keep the baby in the NICU because it is routine, or easy. They keep the baby in the NICU because that is what the baby NEEDS to get better. They decided to do 10 day of antibiotics instead of 7 becuase of the chance of the infection returning.

< It is easy to tell a mother who needs to drive into the hospital to feed "if you just come in every 3 hrs, your baby will be fine.>

You insinuate that they make that statement in a cavalier manner. From the way my friend has described the nurses and the care there, they have a desire for the child to be more than "fine". I don't think it is fair to assume that the medical staff recommended that feeding schedule so the baby would be "fine".

<(Why not tell her to just camp out in the hospital all day, and perhaps even provide an overnight bed? >

The nurses have offered to allow her to "room in" at least once before she goes home. They usually only do it when the mother is admitted, but the nurses said they could arrange for her to do it at least once before the baby goes home, and she is going to do it.

<Any mom I know who has breastfed a baby in NICU pretty much stays all day--night time accommodations depends on the hospital.)>

What do you mean "any mom I know", have you known several? did all their situations allow them to be at the hospital all day, or did they have other children to care for? Did their emotional and physical state allow them to stay at the hospital all day? That is purely individual. If someone has other children to care for and has just gone through the physical and emotional toll of a labor and crisis (newborn being sick), their physical well being is important and it may NOT be good for that mother to stay at the hospital all day.

<Pediatricians are NOTORIOUS for giving inaccurate breastfeeding advice. Many of their own children were not breastfed.>

And many were breastfed.....just like the general public. What difference does that make?

< In fact, formula companies will give pediatricians and obstetricians a year's supply of formula free when they have a baby--because they know that if the Dr. doesn't have a breastfed baby, they will not promote breastfeeding as strongly.>

That is about formula companies and their marketing campaign, not what pediatricians actually recommend or do themselves. Sure they want that MD to be a spokesperson for their brand when talking to patients, but I doubt a pediatrician has had a baby and decided NOT to breastfeed because a year worth of formula just arrived in the mail.

<Some babies will do okay on a 3 hr routine. In some cases it does work. Especially for sick babies. Why? Because they are too tired to complain much.>

Some babies will do OK? How about some babies THRIVE on it! I know my son did and this baby seems no different. This is not working because she is "sick". In fact what is so frustrating to my friend, is that she (the baby) is doing so well, but still can't come home because she has to finish the IV antibiotics. Her pneumonia has nearly cleared up, and there is not other medical problems.

<But one needs to look at long term goals. If your friend is not pumping for those two missed feedings (and perhaps even another time since pumping does not stimulate milk production as well as nursing does), she is risking her milk supply at about 4 months.>

How can you make such a general statment about a function that is so diverse in women? Women have undersupply, oversupply and adequate supply in varied situation. Her long term goal can be met whether she pumps once a night or four times a night. You cannot link what she does for 10 days after a baby is born, to what her milk supplly is going to do in four months. That is absurd! God made the body to adjust to the child's need. That baby is nursing great, and has been since day 1. Once home, that mother's body is going to adjust to what the baby needs, that is the way God made us! All that aside, she is pumping once in the middle of the night.

"Actually, even if she is pumping those sessions, she may be compromising her milk supply. Will she *definitely* have milk supply problems? No. But she is playing Russian Roulette--she will not know if it is "okay" until it is too late to change."

To late to change at 10 days old? Hardly, the baby is just beginning. There are many ways of boosting your milk supply that are very successful. I think it is a bit dramatic to say "russian roulette" at this point.

The bottom line is, this baby is fed every 3 hours and she is gaining weight and getting better, hardly a risky practice it seems. I agree that all babies will not respond to this, but I would hardly call this dangerous.

Kelly

How is 5 days enough time to tell that baby is thriving because of the schedule? Many newborns are sleep the first week or two and many moms are acurately told that baby should be fed at least every three hours until baby can reliably cue for more. If that happens to only be every three hours that's fine. The problem comes when baby starts cueing for food before the three hours is up and noone pays attention.

<<<I agree that all babies will not respond to this, but I would hardly call this dangerous.>>>

How can it not be dangerous when all babies won't respond to it?