When a baby is born and is placed on his mother's chest, skin to skin, professionals make a first assessment on-site to see that everything is going well and that there is no reason to start any urgent medical action. After a while, when he has done the first shot and is calm, he is weighed, measured and a more thorough assessment is made.
While he is in the hospital, if the mother gives birth there, a pediatrician visits him every day, or perhaps less frequently, but always on the last day of admission to discharge him. The day you finally go home with your baby is very variable, it depends on the policy of each hospital, but it is around 2-3 days if the delivery is vaginal and 4-6 days if it is by caesarean section.
This means that, on most occasions, on the fourth and fifth day the baby is already at home, and as a general rule, these are usually the days when problems begin, in general, and especially with breastfeeding. Therefore, and although many parents do not do so and perhaps many health centers either, The baby's first visit to the pediatrician or nurse should be before the age of one week.
What happens the first days?
As we all know, as we all know, the first 2-3 days in the hospital (at home or wherever) the baby just does a little breastfeeding and sleep. What it takes is colostrum, a substance specially prepared to provide everything the baby needs and to start doing his first digestions. As colostrum comes out in a small amount (it should be that way), the first few days lose some weight. That's why when a baby leaves the hospital he leaves with a book in which he points birth weight and discharge weight, which is always inferior.
So mom and dad come home
Then, the parents leave and no longer have to return to the hospital unless the weight at discharge is very low, and then they give you an appointment to do a two-day check, for example. What must happen is that, with the rise in milk, the baby begins to eat more and more food and the weight begins to rise again. If so, the two-day weight control (sometimes the next day) will determine that the weight is going up and then the witness is passed to the pediatrician and the health center nurse. If this is not the case, the action to be followed is valued (give more margin, give a bottle, re-enter the baby, etc.).
Sometimes, on the fourth and fifth day problems appear
The first few days, as I say, they lose a little weight and, although they are clutching their chest, they seem to sleep more than they eat. The fact is that many babies continue to do this when they are at home and the weight may not be getting enough. It may also happen that the first days are very sleepy, but from the moment they are at home, they are more awake and complain more (or much more) and the parents are full of doubts. It may happen, too, that breastfeeding is not going very well and that is when, with advice from grandmothers, aunts, cousins and neighbors distrust appears in the mother and the temptation to go buy the first bottle of artificial milk.
In other words, The baby you know from the hospital is not the same one you have at home, and the answers to the questions that that baby generated for you, that almost all day slept, no longer work, because now he does different things. In addition, neither your mother nor your father are the same as there, because on the maternity floor you felt surrounded by family visits and by that bell that made a nurse appear and solve your doubts. But at home, the only doorbell that is outside the door is the one that gives access to those visits that sometimes, rather than clothing, still make you feel more hesitant.
The first visit of the pediatrician or nurse should not be delayed
Therefore, as a nurse, I am very clear that the first visit in the primary care center, the one that transfers the medical control of the baby from hospital professionals to CAP professionals, must be as soon as possible, in the first week of life if it can be.
It is not a matter of distrust or a question of taking away from parents their ability to care for their baby, because we know they have it all, and if they do not have it, they have the desire and motivation to learn. It is simply a "see that everything is going well" or, if something goes wrong, "see it before a wrong solution appears."
Often, to go when the baby is already 10 days or two weeks, the mother explains that she is giving him a bottle because he can no longer support the cracks, because the baby cried a lot or because he feels he does not have enough milk. Often, to come later than recommended, parents explain that he eats very well and sleeps great and when taking the baby we realize that it seems that he has plenty of skin, because weight loss is important, so much, that the baby sleeps and sleeps because in reality he is just eating.
That is why the visit should not be delayed, because if everything goes well, "go ahead, continue as until now that you are doing great", but if something goes wrong, you can act to prevent solutions that do nothing but bother. A bottle that is not necessary is an interference for the baby, who has to eat different from the breast and the nipple and for the mother, whose production is hindered by a milk that comes from outside, which leaves the baby asleep for 3 or 4 hours and that makes him understand, to his brain, that this break occurs with the amount he suckled, deciding to keep or decrease production a little, when what is sought is precisely the opposite.
The statistic says that 84.8% of infants leave the hospital taking breast milk and that at 4 months of age the figure has already been reduced to 53.7%. We do not know the exclusive breastfeeding data at the month of life, but it would be very interesting to know because I am sure that there are many, but many, babies who are already taking a bottle. If it is by maternal decision, I say nothing, of course (as in my CAP, where this is our daily bread), but if it is for lack of information, because we could have acted before, yes.
That your pediatrician solves it with a bottle?
Do you have problems with breastfeeding, do you go right away and the first or only solution of your pediatrician or your nurse is a bottle? You may want to go to a breastfeeding group to see what they think about it. It is a shame, but many professionals do not know very well how to act and, in the absence of solutions, they pull one that does not fail: "Well, if with your chest and your milk no, give it another". And it's a shame because many times you can solve the problems without giving the baby another milk.
What has lost a lot of weight? I am the first to recommend a bottle and as much as the baby wants, because then the important thing is not to eat breast milk, but to eat. That it takes weight, that it becomes strong, that it begins to be more awake, that it cries with more force, that it does not fall asleep in the second blow to the tit and that, little by little, it sucks more and better. The time will come to remove those bottles later, but if the baby needs it, you don't have to play with it.
Now, as I say, there is often room to try other things, and there is, especially, if you go on time. Therefore, I repeat, the first visit of the pediatrician or the nurse should be, if possible, before reaching one week of life.
Photos | Thinkstock
In Babies and more | Myths about breastfeeding: "With a caesarean section the rise in breast milk takes longer," Rise in milk after childbirth: how to avoid problems ?, "Stop breastfeeding your child so that your breasts rest": the latest myth about breastfeeding in the mouth of a midwife
