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Just to follow up with the last post. The hospitals have soy based formulas if neccessary.
I always encourage parents to not approach things with the 'what if my baby' mentality. It is better for them to start w/ normal formula (in this case) and to see what happens.
A personal recommendation, if you decide that you will be an exclusive breastfeeder but desire formula for the first days of life or for emergency back up I would use GoodStart. It's easier to digest and the newest version includes cultures that mimic those of breastmilk-the closest thing we've got to Breastmilk and may be easier to transition between formula and breastmilk.
I always encourage parents to not approach things with the 'what if my baby' mentality. It is better for them to start w/ normal formula (in this case) and to see what happens.
A personal recommendation, if you decide that you will be an exclusive breastfeeder but desire formula for the first days of life or for emergency back up I would use GoodStart. It's easier to digest and the newest version includes cultures that mimic those of breastmilk-the closest thing we've got to Breastmilk and may be easier to transition between formula and breastmilk.
Every hospital has a different system. However, at Sibley they rotate Similac and Enfamil. If you happen to deliver during a month when Similac is being distributed simply request Enfamil and they will switch it. Also, when it is time for your discharge be sure to request the Enfamil giftbag instead of the Similac version.
And yes! it is best to start w/ the formula you want to continue using. Changing formulas can cause GI upset (loose stools, constipation, gas etc). If you need to change formula (perhaps because baby is intolerant of a specific brand) be sure to follow the recommendations on the label to transition baby off one formula onto another over the course of a week to ease the process.
Best Wishes
And yes! it is best to start w/ the formula you want to continue using. Changing formulas can cause GI upset (loose stools, constipation, gas etc). If you need to change formula (perhaps because baby is intolerant of a specific brand) be sure to follow the recommendations on the label to transition baby off one formula onto another over the course of a week to ease the process.
Best Wishes
You are most welcome.
Indeed! It sounds as if you little one truly needed supplements. When a baby receives phototherapy and has jaundice it is important that they are adequately hydrated (due to continuous heat source) but also to readily eliminate the bili levels. This is standard and the quicker you can correct her bili levels and her sugars the quicker you could resume breastfeeding. The intent is not to keep her on formula etc but to rather stabilize her and ward off complications.
Indeed! It sounds as if you little one truly needed supplements. When a baby receives phototherapy and has jaundice it is important that they are adequately hydrated (due to continuous heat source) but also to readily eliminate the bili levels. This is standard and the quicker you can correct her bili levels and her sugars the quicker you could resume breastfeeding. The intent is not to keep her on formula etc but to rather stabilize her and ward off complications.
Insiders viewpoint...
In the hospital it is your OB who performs the circ. If your OB is not available, than whoever is on-call for your OBs practice will do the procedure. If you come to the hospital and the house OB performs the delivery, they will also perform the circ.
I would like to politely correct the previous commenter, peds do NOT do circs 'more' often. Very rarely does a family leave the hosptial without a circ desiring a circ unless it is for religious and/or medical reasons.
In the hospital it is your OB who performs the circ. If your OB is not available, than whoever is on-call for your OBs practice will do the procedure. If you come to the hospital and the house OB performs the delivery, they will also perform the circ.
I would like to politely correct the previous commenter, peds do NOT do circs 'more' often. Very rarely does a family leave the hosptial without a circ desiring a circ unless it is for religious and/or medical reasons.
An inside viewpoint..
Baby's are routinely given Hepatitis B vaccinations during their stay at the hospital. Keep in mind that if your pediatrician has privelages at the hospital it is your pediatrician who ordered it. If your ped does not have privelages, than the house neonatologist/pediatrician does. All hospitals require consent prior to giving the Hep B vaccine so you have the option to decline. Instead of wondering, I would recommend contacting your pediatrician prior to delivery and inquire about their preference. Most don't mind the shot being given at the hospital and others ask that you wait because they give pediarix (combined vaccines) or establish different schedules. Hospitals have no preference.
Baby's are routinely given Hepatitis B vaccinations during their stay at the hospital. Keep in mind that if your pediatrician has privelages at the hospital it is your pediatrician who ordered it. If your ped does not have privelages, than the house neonatologist/pediatrician does. All hospitals require consent prior to giving the Hep B vaccine so you have the option to decline. Instead of wondering, I would recommend contacting your pediatrician prior to delivery and inquire about their preference. Most don't mind the shot being given at the hospital and others ask that you wait because they give pediarix (combined vaccines) or establish different schedules. Hospitals have no preference.
Hello Everyone,
First I will say that personal gifts are not allowed, but group gifts like food is. And you bet, chocolates are the first on the list. But for a creative thank you try bagels and cream cheese in the morning or a selection of muffins, a fruit bowl goes over well (especially the new trendy fruit arrangements), one family brought in a basket of nonperishables like microwave popcorn, puddings etc so that the food would be available to all the nurses on the different shifts.
By no means do your nurses expect gifts. But it is very appreciated. I am a NICU nurse so some of my families are with us for weeks at a time and we establish close bonds. But regardless of duration of stay, it's always nice to be recognized and appreciated
Thanks for being so thoughtful!
First I will say that personal gifts are not allowed, but group gifts like food is. And you bet, chocolates are the first on the list. But for a creative thank you try bagels and cream cheese in the morning or a selection of muffins, a fruit bowl goes over well (especially the new trendy fruit arrangements), one family brought in a basket of nonperishables like microwave popcorn, puddings etc so that the food would be available to all the nurses on the different shifts.
By no means do your nurses expect gifts. But it is very appreciated. I am a NICU nurse so some of my families are with us for weeks at a time and we establish close bonds. But regardless of duration of stay, it's always nice to be recognized and appreciated
Thanks for being so thoughtful!
I am a Neonatal Intensive Care Unit RN cross-trained in Family Care (also known as Postpartum). I wanted to reply to the string of comments regarding hospitals and the use of supplementation.
First and foremost I want to address the fact that everyone will have a completely different experience. Labor experiences, birth outcomes, your staff etc all contribute to your experience. Although it is regrettable that some patients will leave unsatisfied with their experience, I would not conclude that their experience is 'typical'.
So, I would like to share a nurses viewpoint when it comes to breastfeeding and bottlefeeding and give you an inside look as to why supplementing may be neccessary. There are only a handful of scenarios in which it would be deemed neccessary to supplement oppose to breastfeed a newborn. These include an excess weight loss, jaundice, hypoglycemia, maternal disease where breastfeeding is contraindicated or maternal disease that separates mom and baby in the initial postpartum period, and prematurity. I will address these briefly so that there is a general understanding as to why a baby must be supplemented in these situations.
Excess weight loss- Yes! All babies lose weight in the first 10 days of life. Normally up to 10% weight loss is acceptable and expected. However, some babies lose weight incredibly quickly, their output is more than their input and consequently they become dehydrated and for some babies, especially those who are starting at small weights, are put at risk.
Jaundice- Jaundice is an accumulation of bilirubin (byproduct of red blood cells) which turns the skin yellow. Your baby will be monitored for jaundice as nearly 80% of babies despite age or weight will develop it. The primary mechanism for eliminating bili is through urine/stool excretion. To accelerate this process, supplementation is often used sometimes accompanied with phototherapy. Dehydration is also of concern when babies are receiving phototherapy due to the continual heat source.
Hypoglycemia- babies who are extremely low and extremely high in birth weight, babies born to moms with gestational diabetes and occassionally the healthy, term baby of appropriate weight can be at risk for hypoglycemia (low sugars). Those at risk will be monitored periodically to ensure their sugars are regulated. Others will be tested on if they are symptomatic (jitteriness etc). There are protocols and it is dependent on the sugar levels. If babies are borderline, we may encourage mom to breastfeed and than 30 mins later we will repeat the test to see if they sugar levels increased. In cases where the babys sugars stay low despite feeds, supplementing them is utilized to prevent persistent hypoglycemia which can lead to seizures etc. In other cases where the babies sugars are at a very low level, supplement is given not breastfeeding because the colustrum provides an insufficient level of glucose and volume in the first hours of life. And for babies with critical lows, IVs are started.
Maternal disease- Some diseases such as HIV breastfeeding is contraindicated. Sometimes moms have complications with their pregnancy/delivery and end up on medications that are contraindicated for breastfeeding. And in other instances, moms are so ill they remain in the labor/delivery unit or even Intensive Care for observation. Naturally these babies remain with the NICU as 'border' babies and are often supplemented because mom is not well enough to breastfeed and may not be well for a few days.
Prematurity- Babies born prematurely are often low in birth weight, have feeding difficulties, require additional calories for growth and support and have an increased need for stable glucose for proper development, temperature regulation etc.
In these scenarios, nurses alert neonatologists or pediatricians regarding the babies status and often it is the MD who orders supplementation. Only per protocol would a nurse directly request supplementing a child (ie in the case of a hypoglycemic baby). Only if a parent requests supplement is it provided without an order.
It is important that new moms realize that as much as we respect your wishes to breastfeed, there are situations that render a different careplan. This is NOT the hospitals or nurses or doctors desire to thwart you from breastfeeding. Our primary interest is to ensure you go home with a healthy baby. The lasting effects of untreated hypoglycemia, jaundice, weight loss etc are delayed development, neuro damage, even death. We must remember that the initial period after birth is quite tramatic and requires alot of transition for the newborn. It is not uncommon for babies to struggle in the first day of life regarding breathing, temperature regulation, sugar regulation etc. It is the role of your nurse and other providers to continously monitor the infant for any signs of distress, and consequently treat them if needed.
It is unsafe to presume every baby is healthy and will not have complications. Although most of us moms walk in the door with our birthplans and feeding plans in pocket, it is very common for those plans to be modified because of unpredictable circumstances. Unfortunately very little is published to educate and prepare parents for the "what if's" and we are misguided into believing that we can control every detail of our hospitalization. Remember mentality is everything. I experience a wide range of attitudes from parents who come with open minds and flexibility and do not stress about neccessary interventions to those who want to justify why their plans are sufficient and refuse to acknowledge their babys health can be put at risk.
The best you can do is to communicate. Let everyone know what your hopes are. If you find yourself in a situation where plans change, understand the rationale. Ask how you can support your baby in the process (ie breastpumping etc). And although it might be annoying to have to repeat yourself every shift, understand that parents change their plans just as frequently and our role is to support those decisions by knowing how we can best care for you and your newborn while we are on duty.
Thank you for listening. Best wishes to all the moms to be!
First and foremost I want to address the fact that everyone will have a completely different experience. Labor experiences, birth outcomes, your staff etc all contribute to your experience. Although it is regrettable that some patients will leave unsatisfied with their experience, I would not conclude that their experience is 'typical'.
So, I would like to share a nurses viewpoint when it comes to breastfeeding and bottlefeeding and give you an inside look as to why supplementing may be neccessary. There are only a handful of scenarios in which it would be deemed neccessary to supplement oppose to breastfeed a newborn. These include an excess weight loss, jaundice, hypoglycemia, maternal disease where breastfeeding is contraindicated or maternal disease that separates mom and baby in the initial postpartum period, and prematurity. I will address these briefly so that there is a general understanding as to why a baby must be supplemented in these situations.
Excess weight loss- Yes! All babies lose weight in the first 10 days of life. Normally up to 10% weight loss is acceptable and expected. However, some babies lose weight incredibly quickly, their output is more than their input and consequently they become dehydrated and for some babies, especially those who are starting at small weights, are put at risk.
Jaundice- Jaundice is an accumulation of bilirubin (byproduct of red blood cells) which turns the skin yellow. Your baby will be monitored for jaundice as nearly 80% of babies despite age or weight will develop it. The primary mechanism for eliminating bili is through urine/stool excretion. To accelerate this process, supplementation is often used sometimes accompanied with phototherapy. Dehydration is also of concern when babies are receiving phototherapy due to the continual heat source.
Hypoglycemia- babies who are extremely low and extremely high in birth weight, babies born to moms with gestational diabetes and occassionally the healthy, term baby of appropriate weight can be at risk for hypoglycemia (low sugars). Those at risk will be monitored periodically to ensure their sugars are regulated. Others will be tested on if they are symptomatic (jitteriness etc). There are protocols and it is dependent on the sugar levels. If babies are borderline, we may encourage mom to breastfeed and than 30 mins later we will repeat the test to see if they sugar levels increased. In cases where the babys sugars stay low despite feeds, supplementing them is utilized to prevent persistent hypoglycemia which can lead to seizures etc. In other cases where the babies sugars are at a very low level, supplement is given not breastfeeding because the colustrum provides an insufficient level of glucose and volume in the first hours of life. And for babies with critical lows, IVs are started.
Maternal disease- Some diseases such as HIV breastfeeding is contraindicated. Sometimes moms have complications with their pregnancy/delivery and end up on medications that are contraindicated for breastfeeding. And in other instances, moms are so ill they remain in the labor/delivery unit or even Intensive Care for observation. Naturally these babies remain with the NICU as 'border' babies and are often supplemented because mom is not well enough to breastfeed and may not be well for a few days.
Prematurity- Babies born prematurely are often low in birth weight, have feeding difficulties, require additional calories for growth and support and have an increased need for stable glucose for proper development, temperature regulation etc.
In these scenarios, nurses alert neonatologists or pediatricians regarding the babies status and often it is the MD who orders supplementation. Only per protocol would a nurse directly request supplementing a child (ie in the case of a hypoglycemic baby). Only if a parent requests supplement is it provided without an order.
It is important that new moms realize that as much as we respect your wishes to breastfeed, there are situations that render a different careplan. This is NOT the hospitals or nurses or doctors desire to thwart you from breastfeeding. Our primary interest is to ensure you go home with a healthy baby. The lasting effects of untreated hypoglycemia, jaundice, weight loss etc are delayed development, neuro damage, even death. We must remember that the initial period after birth is quite tramatic and requires alot of transition for the newborn. It is not uncommon for babies to struggle in the first day of life regarding breathing, temperature regulation, sugar regulation etc. It is the role of your nurse and other providers to continously monitor the infant for any signs of distress, and consequently treat them if needed.
It is unsafe to presume every baby is healthy and will not have complications. Although most of us moms walk in the door with our birthplans and feeding plans in pocket, it is very common for those plans to be modified because of unpredictable circumstances. Unfortunately very little is published to educate and prepare parents for the "what if's" and we are misguided into believing that we can control every detail of our hospitalization. Remember mentality is everything. I experience a wide range of attitudes from parents who come with open minds and flexibility and do not stress about neccessary interventions to those who want to justify why their plans are sufficient and refuse to acknowledge their babys health can be put at risk.
The best you can do is to communicate. Let everyone know what your hopes are. If you find yourself in a situation where plans change, understand the rationale. Ask how you can support your baby in the process (ie breastpumping etc). And although it might be annoying to have to repeat yourself every shift, understand that parents change their plans just as frequently and our role is to support those decisions by knowing how we can best care for you and your newborn while we are on duty.
Thank you for listening. Best wishes to all the moms to be!
Sibley offers Enfamil, Similac on a rotation basis. They do stock GoodStart, so if interested please ask your RN for it specifically. All three brands supply 'gift' bags.
Also, if babies have special dietary needs (ie premature infants or lactose intolerant etc) additional formulas are available per MD order
Also, if babies have special dietary needs (ie premature infants or lactose intolerant etc) additional formulas are available per MD order