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Thread: Returning to work - night shift RN

  1. #1
    Join Date
    Sep 2009
    Location
    Salisbury, MD
    Posts
    46

    Question Returning to work - night shift RN

    Hi all,
    I am headed back to work in two weeks and i am a night shift RN (L&D) who works 3 -12 hour night shifts a week. So i have several questions.
    DS is 10 weeks old and is still eating every 2 hours or so during the day. I plan on feeding him before leaving for work and then when i get home in the mornings and possible waking up in the middle of the day to feed him around lunch time and then again before returning to work. Does that sound like enough? Luckily I will only have to work two nights back to back so i should be ok. I will exclusively breastfeed when I am off.

    My question is how to I prevent over feeding? My husband and mother in law will be watching him while i'm gone and/or sleeping. Give him small frequent bottles of 2-3 oz every couple of hours versus bigger bottles every 3?

    Pumping shouldn't be a problem at work as there are a bunch of us lactating L&D nurses so they are used to it Although I am worried about my supply as I have lots of milk in the freezer that is "not good" anymore because of a suspected protein allergy so I am now dairy / soy free and starting to slowly build up my reserve again (I usually get 1 oz after a feeding and pump 2-3 times a day) sometimes I get less though, so frustrating!

    He comfort nurses a lot still too as he has tummy issues (GAS) I'm worried about his comfort when I am not there as he won't even take a pacifier. sigh.

    Any suggestions from other night shift moms?

    thanks
    -----------------
    Tiffany
    Mom to a beautiful baby boy born 8/18/09
    At our house we and love our
    If I'm here I'm

  2. #2
    Join Date
    Oct 2008
    Location
    St. Louis, MO
    Posts
    2,242

    Default Re: Returning to work - night shift RN

    Here is a really cool milk calculator. A general rule of thumb is that your baby will need 1 oz. to 1.5 oz. per hour that you are away.


    I'm Laura, mamma of 2

    5-27-06

    8-30-08

    We love and

    We have been nursing for over 2 years now!

  3. #3
    Join Date
    Jan 2006
    Posts
    18,063

    Default Re: Returning to work - night shift RN

    tips form this link:

    http://www.llli.org/llleaderweb/LV/LVIss1-2009p12.html



    Bottle-feeding can be made to more closely approximate the normal through the following steps:

    1. To begin, choose the bottle teat with the slowest flow. The baby needs to suck to get milk. Our goal is to preserve breastfeeding. To avoid the possibility of latex allergies, avoid latex (brown) teats. Avoid short, stubby teats. Generally, longer teats that widen at the base encourage the baby to make a wide-open gape, even on the bottle. This can make it easier to transition back to the breast.

    2. Support the baby securely. Offer the bottle with the baby in as close to a sitting position as is comfortable for him. This allows the baby to control the flow of milk more easily and requires active suckling on his part.

    3. With the bottle teat held to his lips, the nipple base resting on his chin and the nipple pointing up toward his nose, stroke the baby's lips with the teat, using a feather-like touch, to elicit a wide open mouth -- as if the baby were going to breast. Avoid forcing the teat between closed lips. Let the baby mouth it.

    4. Use a straight bottle and hold it horizontally so that gravity is not forcing fluid into the baby's mouth. The baby needs to suckle for food, in a manner as similar to breastfeeding as possible. These measures avoid possible choking and/or aspirating. Let's not frighten the baby.

    5. The mother's nipple reaches the point in the baby's mouth where the hard palate meets the soft palate. The bottle nipple should, too, so that it feels to the baby as much like breastfeeding as possible. Nipples having a very wide base may look a bit like a breast but are so big and firm that the baby gets only the tip of the teat in his mouth.

    6. Use a teat that is narrow enough for the baby to get his mouth around and encourage him to take as much of the bottle teat as possible into his mouth. Generally, the baby's lips will look nicely flanged out and will be touching the bottle. The baby should "latch deeply" onto the bottle, just as the baby would latch deeply onto the mother's breast.

    7. Initially, the baby may need to be burped much more often than one might expect. While he's learning, he may swallow a lot of air.

    8. As a rough guide, the bottle-feeding should take about 20 minutes. If a baby finishes a full feeding in less than 10 minutes, it may mean the bottle is flowing too quickly. Feedings that regularly take 30 or more minutes may indicate the baby is not able to remove milk effectively from the bottle being used. Since bottles are subject to manufacturing errors, it is important to check to make sure there is a hole in the nipple when a baby is unable to feed from a bottle. Even within a package of three teats, there may be significant variations in flow. Discard any teats with a flow that is too fast or too slow.

    9. One additional step may ensure that the baby doesn't overeat: Before you believe he is full, slip the bottle from his mouth and rest it against his lips as you did at the start of the feeding. He may eagerly and immediately gape for it. As soon as he does, give it back. After another 10 or so swallows, repeat. This is your way of asking him, "Would you like more?" His answer will change through the feed from "Yes," to "Perhaps," to "No."

    More information on this method of feeding is found in Dee Kassing's article in the Journal of Human Lactation, "Bottle-Feeding as a tool to Reinforce Breastfeeding." Kassing includes a message parents need to know: "When a baby is put in control of the feeding and allowed to take as much as he needs, there is less chance the baby will be underfed or overfed supplement" (p. 59).

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