One of the moms who attended my bf class two weeks ago delivered just a
few days after the class.  She began having PIH problems and was
induced, 36 weeks.  Although they have a very good LC at the hospital
where she delivered, one of the "bf staff" told her that she HAD to give
the twins bottles while she was there because they were not latching
well yet.  The NICU at this same facility cup feeds the bf babies,
arghhh!
Mom called me, crying uncontrollably, last eve.
I went over to hold her hand and offer some moral support.

What I found were 2 very jaundiced (colored like pumpkins), cold babies,
neither of which were latching on at all.  Grandmother had been posting
the "pees and poops", which appeared marginal, until I watched her post
a poop when in fact there was just a tiny smear.  It also appears that
she has had difficulty telling the difference between a wet diaper and
one slightly soiled from the Vaseline gauze pad for the circumcision.
The babies were cool to the touch, I took temps, they were only 96 F
rectally! One was dehydrated, mildly, the other not too much so.  Both
had fontanels that were slightly depressed.  Obviously I got the pedi on
the phone immediately.

The moral of the story for me: Be VERY specific about exactly what
constitutes a wet/dirty diaper, and encourage moms to give that same
info to whoever is helping them.  Request that the moms insist on having
an eval. by the hospital IBCLC prior to d/c (discharge), hopefully they
have one.  And, apparently I need to mention what constitutes
appropriate apparel for small newborns to avoid what could have easily
been a disaster, in this case.  What if she hadn't called!, what if I
hadn't been able to get a sitter!

The current plan is: dress appropriately for 5# 36 weekers, pump and
syringe feed 1-2 oz.s every 2-3 hours (I base this amt. on what they
took for me while I was there), take to pedi this am for weight and bili
check (temp also of course)I dressed babies and put them in bed with mom
and dad after discussing how to safely co-sleep. While I was there,
noted that mom was quite engorged (6 days pp) sorry, pp= postpartum,
watched as she pumped for 15 minutes and got 13 oz.s of EBM! the last
half of the pumped milk was very thick and yellow with fat.  I don't
think that these babies had hardly eaten since birth, except when mom
got desperate the night before and bottle-fed the EBM.  Mom's nipples
are quite large, making it a challenge to get those little mouths on
well.

What a very close call :(
By the way, mom is a very intelligent, well educated, cardiac RN.  If
this is happening to a mom who attended prenatal bf class, is an RN, and
has help at home, heaven knows what goes on with some of the less
fortunate moms, a scary thought.

Sorry this is so long, really needed to express my concerns to you all.
Thanks for listening.

--

Denny Rice, RN, IBCLC
Dallas Texas USA

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