My first thought with your puzzle baby is to get more volume in to increase the wet dippers to 8 daily. I would rule out dehydration and then try a Medela product called an SNS. This can also be fashioned out of a 5 french feeding tube and a syringe of any size to tape long the breast and insert into the corner of baby's mouth to provide expressed milk right with the direct nursing.
Assuming this baby is too smart for that and refuses to allow it, breast compression to increase volume would be my last thought. This little one needs more volume to boost her diapers and her weight. Check that mom's diet couldn't be supplemented somehow especially with healthy fats since all other avenues seem to be exhausted.
Wendy Shore RNC, IBCLC In Pa
Sent from my Verizon Wireless 4G LTE smartphone
<div>-------- Original message --------</div><div>From: LACTNET automatic digest system <[log in to unmask]> </div><div>Date:03/24/2015 12:00 AM (GMT-05:00) </div><div>To: [log in to unmask] </div><div>Cc: </div><div>Subject: LACTNET Digest - 22 Mar 2015 to 23 Mar 2015 (#2015-124) </div><div>
</div>There are 3 messages totaling 138 lines in this issue.
Topics of the day:
1. Fingerfeeders
2. Puzzle baby
3. algorithm for supplementing a brestfed baby
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Date: Mon, 23 Mar 2015 13:36:48 +0000
From: "Walker, Laura (Our Lady of Lourdes Memorial Hospital/Binghamton)"
<[log in to unmask]>
Subject: Fingerfeeders
Good Morning,
Does anyone who works in the hospital setting use the Hazelbaker Fingerfeeder in house? Would you email me privately?
Thank you!
Laura
[log in to unmask]
Laura Walker RNC-LRN, IBCLC, RLC, CEIM
Our Lady of Lourdes Memorial Hospital
169 Riverside Dr.
Binghamton, NY 13905
(607) 798-5423
"Imagine that the world had created a new 'dream product' to feed and immunize everyone born on earth. Imagine also that it was available everywhere, required no storage or delivery, and helped mothers plan their families and reduce the risk of cancer. Then imagine that the world refused to use it." ~ Dr. Frank Oski.
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Date: Mon, 23 Mar 2015 13:06:52 -0400
From: Molly McMillion <[log in to unmask]>
Subject: Puzzle baby
I am posting with permission about a baby I saw in clinic this morning.
Maybe it's just my "Monday morning fuzzy headedness" but I can't quite tell
what the problem is with her. Baby was born February 3, and is mom's 5th
baby. The pediatric provider suggested I see this baby as "she has
slipped from the 75th to the 25th percentile in weight". Birth weight was
8lb 10oz and now at 7 weeks she is 9lb 12.9oz --baby has not lost weight
but the provider is concerned about slow weight gain and mom is feeling
very frustrated. Of note to me right away is that the provider stated that
the baby is completely intolerant to any supplement --formula or mother's
expressed milk, she will not take supplement by cup, bottle, or syringe.
The few times they have been able to cup feed this baby she spit it right
back up. This baby appears 'healthy' hydrated and 'happy' alert but not
fussy and mom notes that she is 'very laid back'. Mom reports that all her
babies have been 'lip tied' but that with this baby soreness improved much
faster. She denies nipple soreness or pain while nursing at this time. I
observed baby's latch and she latches well but comes on and off the breast
multiple times during a feeding before she falls asleep. I wondered about
supply (low or over supply) but neither appears to be the case. Mom states
that while she had a period of 'nursing all the time' she nurses every 2-3
hours during the day and would probably go all night but mom wakes her to
feed in light of slow weight gain. Diaper count could be better, 4-5 wet
diapers a day and 1 stool a day--which ranges from yellow to green.
I see mild lip tie and no tongue tie, but this baby will NOT suck on a
gloved finger or ANYTHING except mom's breast and a 6 month + size 'mam'
pacifier which the baby only has because one of her older siblings found it
in an old diaper bag and popped it in her mouth one day. There is no
apparent oral issue here and no reason for low tone but that is the only
explanation I can think of. THOUGHTS ANYONE?
your input is appreciated!!
Molly Scarborough McMillion RN, BSN, IBCLC, CCE, CPST
Lactation Consultant, Childbirth Educator
Special Projects Consultant - West Virginia Perinatal Partnership
Right from the Start - Direct Care Coordinator
304.667.4362 www.babylovegbv.com
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------------------------------
Date: Mon, 23 Mar 2015 21:33:31 -0400
From: Ellen Rubin <[log in to unmask]>
Subject: Re: algorithm for supplementing a brestfed baby
There is information about supplementation tools and a table for "supplementation required to increase weight gain" on page 72 of Catherine Watson Genna's "Selecting and Using Breastfeeding Tools".
Ellen Rubin MA, IBCLC
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End of LACTNET Digest - 22 Mar 2015 to 23 Mar 2015 (#2015-124)
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