Hi Everyone,
  I apologize for coming in your space. I am at work and unable to post from this computer or search archives from this email. 
  I have a mom (permission to post. Her baby is 14 weeks of age. SGA at birth 5lbs 5 oz. She is now a little over 8 lbs. slow to gain. Mom has a fast let down.
  She visited her Pediatrician yesterday followed up with 2 wk appointment because she didn't feel the weight gain was good. Gained 6 oz in the 2 wks her lowest wt was 4lbs. 8 oz. Mom has alot of milk. Baby nurses freguently but most of the time one side only. The baby choked during the let down in the Ped office as the Ped came into the room. She scolded the mom for low weight. Told her to start supplementing formula to get more calories and wanted her started on Prevacid in case she has acid reflux. The mom is a pharmacist and breastfed her sibling over a year. The baby is very content following a feeding is retaining all feedings. Mom is at work so she gets bottles of breastmilk from caregiver. I neglected to ask mom how much she is feeding at daycare. Mom states she has several soaked pale urine diapers and three very large yellow seedy stools every day. She called me probably more to vent. Said that if she were a first time mom would have went right to formula. She
 wants to continue to breastfeed. Let me know if I'm in error here. I suggested that she let the baby nurse as long as she wants to on one side if she is nutritively feeding. If interested in feeding other side let her. I wouldn't start the Prevacid yet until she starts showing more symptons. She could express milk first until she gets the first let down and then let baby nurse to be able to get more high fat calories in case she does have alot of milk that baby is filling with more foremilk. Your suggestions are welcome and appreciated.
  Terri Klein RN CLE CLC

Nikki Lee <[log in to unmask]> wrote:
  Dear Friends:
What would be the differential diagnosis between a posterior tongue tie 
and a dysfunctional suck as a result of birth trauma?
warmly,

Nikki Lee RN, MS, Mother of 2, IBCLC, CCE
Adjunct Faculty, Union Institute and University, Lactation Program
Film Reviews Editor, Journal of Human Lactation
www.breastfeedingalwaysbest.com

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