Neonatal unit - clashing guidelines?

[willisurvive3under2]

I've just had twins and we're in neonatal. No big issues, babies just a bit small. The staff is amazing and I'm getting incredible help. However, some of the advice I was given clashes with what I thought were the accepted guidelines (I had another baby in 2016 so I'm pretty up to date).

• sterilising: as I plan to BF, I've been told I don't need to sterilise pump and bottles if I express. Just soapy water. Is this ok?

• swaddling: it's no longer done as it can cause overheating. What about the lovely Gro Swaddles I've just bought? They are recommended by the Lullaby Trust... 🤔

• dummies: last night the girls wouldn't settle and I was given dummies to try. Reluctantly I did and they worked really well. I think with two babies and a toddler I need to make my life easier so I will use them. But what about establishing BF first?

Any advice from anyone more knowledgeable that me would be welcome! Thanks.

I think you only have to sterilise if using formula.

I don't think sleeping bags count as swaddling - swaddling means their arms and legs are held tight against the baby's body.

I know some are against dummies but they didn't interfer with my son breastfeeding. They also helped his reflux.

Sorry just read you wrote Gro Swaddle. I think swaddling is a bit controversial. I did it...but my health visitor told me not to...

Mine was swaddled on Thursday night and this is a HUGE Trust in SE England !

With both mine I've introduced dummies immediately and not had any trouble establishing breastfeeding too if that helps.

The pump is the big one because whilst it would be incredibly rare for there to be a problem if you did this, there could be. Pumps must be sterilised at least every 24hours. You could draw the attention of the unit to this incident where a baby was left very unwell after being fed with milk form an unsterilised breast pump and cross reference it with pump manufacturer instructions - they all recommend sterilisation. www.cbc.ca/news/health/breast-pump-cronobacter-1.4214341
A premature baby is more at risk than a term baby so the unit should be especially careful.

Dummies are best left until the latch is sorted but there use can be earlier and can be helpful but the real thing to watch out for is that they often lead to reduced feeding and reduced weight gain. Babies suck then fall asleep because they are immature not because they didn't need a feed - if you know that you can balance their use.

The lullaby trust is the most up to date resource on safe baby care, your unit will struggle to show you evidence the trust hasn't already appraised.

scuse the typos!!

I think all those rules are the same as I was told in the NICU (and I was in the super litigious US).

Are your babies able to feed breast/bottle yet or are they tube feeding? I think the “guidelines”/best practice are slightly different in the NICU because a lot of babies are unable to feed at all and this means any sucking - including on a dummy - is encouraged.