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When Katelyn was born at 27 weeks I was
informed that the sucking reflex begins to establish at 32 weeks
- lately I have heard lots of people say it is 35weeks.
Where is the evidence they are basing this
on - Katelyn breast fed from 33 weeks and came home at 36 weeks. At
33 to 34 weeks she would lay sucking her hands - she sucked a very
small dummy at 30 weeks in NICU where the nurses said that this helped her
to develop the sucking refex - babies in the womb suck their hands etc
from quite early and if this is developed and encouraged then Breast
feeding should follow.
Some how in the past 8 yrs the reflex has
gone from 32 weeks to 35 weeks - is this medically proven? OR is
this just medical jargon to keep the baby from the mother for
longer?
Any statistics and studies would be
interesting to see.
Rhonda
-------Original Message-------
Date: Saturday, 27
April 2002 08:13:39 PM
Subject: Fw: prem
care
Dear Jan
I have some info which may help to fill in the big picture so that
you and your client can work through this problem.
Most SCN will give parents the info not to
expect to be able to take their babe home until his feeding reflexes are
fully developed, and that this may take up until his 'due date'. However
if this babe is now 35 weeks he may well be developing his feeding
reflexes- some babes born at 35 weeks thrive from birth
According to current feeding regimes his
"quota" will be either 46 or 56 mls every 3 hours. He will be offered this
amount at 3 hourly intervals not because it is when he is ready for a feed
but because it is in accordance with feeding regimes suitable for most
infants at this stage. Some will wake for feeds but many will not and will
only take a small feed which may or may not be enough to sustain healthy
development.
If he is alert enough to take the breast for
at least 10 minutes and milk transfer is audible during feeding why are
staff gavaging pc the bf?
Perhaps offer this milk via spoon or cup to
appetite ie till the babe goes to sleep
Consider offering all feeds other than bf via
cup or spoon- sure it may take a little longer but will not cause nipple
confusion in a small preterm infant who is just starting to learn how to
suckle. Nipple confusion is never predictable but it is easier to prevent
by not offering alternative nipples. This will also establish whether or
not this infant is going to become exhausted with self feeding- if he is
able to stay awake long enough to take his 'quota' he is probably ready to
bf all day every day in his own home.
Is it possible for the mother to feed more
than once per day? If the babe is able to
take 3-4 breast feeds in a row without tiring he can probably
manage bf all day, again in his own
home.
Nursery staff will have concerns over
continued health and development and unfortunately this can only be
'measured' by weight gains but needs to be considered in line with feeding
performances and other indicators of wellness eg sleeping/wakefulness
patterns.
Are there any staff who will listen to a
feeding plan that you could develop together (mother/midwife/scn staff)
which could be tried for a day or two,
measured and then an agreement to send babe home?
Hope this helps your client
Alesa
Alesa Koziol
Clinical Midwifery
Educator
Melbourne
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