Let, allow, permit
"just to warn you - some nicus will not let you use a SNS and/or are not set up for the mom to spend the night when it's time to move the baby fully to nippling. "
You can buy your own from any lactation station or lactation consultant. The words "let, allow, and permit" ought to be stricken from OB/GYN and Neonatalogy. There is absolutely nothing in the literature to support any such ban and anything that gets in the way of nursing once a baby has grown enough and can handle suck/swallow/breathe pattern (which they need to bottle feed as well). I had the same garbage fed to me at our nicu and I just did not accept it. I brought in the literature, brought in my own LC who was a friend of mine, and got my sns on my own as well since the NICU didn't use them. Once baby is ready to nipple, then your can try your nipple too.
"For example, in my daughter's case, she was nippling all feeds a solid 3 weeks before she was ready to come home. There was no way, had I been breastfeeding (at the time I wasn't) I could have been there for all of them. And we'd fought so hard to get the NG tube out that I was NOT going to make that an issue. "
I preferred the NG tube to bottle feeding, but that was my position after having my first set of twins get nipple confusion in the hospital sabotaging my breastfeeding for months and causing lots of difficulty and pain for me. I breastfed all the time when I was there -once she learned - and they did the NG when I wasn't there per my wishes. And I learned to do NG so I could take her home without having to bottle feed, but once I got home she was doing so well I discontinued the NG tube feedings within a week. Going home on NG tube was not "allowed" in our NICU, except for babies who were being sent home to die. My point was if you send some parents home with dying babies trained to use the tube, why on earth can't I be trained (I already knew how, but they didn't know that). I was the proverbial squeeky wheel. They were happy to get rid of me I am sure, but my baby got the care I felt was best for her.
"Also, our NICU does not usually allow SNS'. It ended up being a moot point with my daughter anyway because she hates the SNS (screams when I try to use it) but just as a heads up."
I have used cup feeding and medicine syringes in the past with my first set of twins as an alternative to SNS or NG tube. Sure the alternatives can be a pain in the beginning, but for someone who feels strongly that you should avoid bottle feeding to minimize challenges to getting baby on the breast, there are several alternatives and a mother who desires to committ to using them shouldn't have roadblocks set up by the NICU staff.
"Domperidone is not accepted in all NICUs as a milk booster. Reglan usually is though. "
I believe Reglan has more serious potential risks/side effects to mother, we have docs here that hate Reglan and prefer Domperidone. And if you can find out that other NICUs do allow something (as I found in our area and pointed out to the neos that I could also just pay for an ambulance transfer to the other hospital if they kept fighting me on things that were clearly about caregiver preference and not across the board neonatal standards of practice). I agree about using herbs with very young preemies, but the milk supply issues usually creep up later when baby is finally demanding and processing more milk and mama has gone sooooo long with only pump and not baby stimulation of her nipples. I would just encourage mamas to plan what they want to do it supply issues come up later on and have sources in place or resources already at home to deal with it.
"Also, be very careful with fenugreek and other herbs. Fenugreek is a L3 (I think) and as such some NICUs do not permit its use in babies under 36-40 weeks.
Don't take this as me correcting you Lorrie

I promise I am not!!! I just know that experiences can differ so much...I figure people should be aware of that

"
No worries, I wasn't offended. I just find that so many women get into a mindset where they won't dare do what their heart tells them they should because some staff person is opposed to it even though Hospital x and y down the street have no problem with it or its actually well documented in the literature,but this caregiver is a stodgy stick in the mud who doesn't grow and change with the times. My decisions were based on the idea that unless they could provide actual evidence or scientific literature(and I usually had perused all the current literature on that topic before we had the discussion) or a really convincing argument against what I wanted to do - I did it. Not everyone wants to go to battle for things the way I did and there is no judgement against going with the flow on my part, but my AP mama lactivist heart made it important enough for me to want do so. Our results with Kalleigh have only made us feel in hindsight that we did a really great job advocating for her.
Lorrie
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