Several people have asked some more questions about this mom/baby dyad.
I've gotten some more clarification from the mom which I will share here:

Meconium was slow to leave his body.  She thinks maybe because of the milk
not coming in "on time".  He got colostrum only for 3 days and then they
started the SNS with formula and it started to transition over.  By a week
the stools were the seedy BM stools (and the formula had been stopped since
the milk came in on day 5-6).  It wasn't pure meconium for a week but it
didn't completely go to seedy yellow until 7 days either...there were a few
days of transitional stools in there.

His lowest weight that she is aware of was 8 lbs 13 oz at discharge (48
hours old.  They were discharged a sunday and on the next tuesday he was
9-1.  He hasn't lost weight since then, but he gains in spurts.  At one
appointment it was noticed he had only gained 1 oz in a few days, then 2
days later it was 4 more oz.  She's been to the ped's office several times
since she is feeling something isn't right even though everyone says it's
fine.  Her instincts were right with her older son who had reflux that
caused him a lot of pain, and that took a month to get diagnosed.

On the right she usually uses the football hold.  She doesn't love that
position but can't seem to negociate another position comfortably for him
very often.  Once in a while she tries cradle and if he puts up with it she
feels the latch is better and more comfortable for her.  The left side is
pretty much mostly cross cradle; he's comfortable in that position on that
side.  The latch is asymmetrical but he takes more of the areola on the
upper part rather than below the nipple despite use of proper technique.
She feels that with the football hold on the right his lower lip rubs the
base of her nipple and drives her insane.

Diapers are changed at every feeding, so it's more noticeable when he's not
really wet.  Today he did have 7 wet diapers which is "within normal" at
least but it is down from his "I'm wet at every feeding" she was seeing.  He
eats roughly 10x per day but she says it feels like more because often it's
the relatching and trying to calm him down to get a little more in him since
he's screaming again...and the feedings run together a lot, particularily at
night.  She doesn't feel it's simple cluster feeding due to the fussiness.

As for the birth, the interventions were really done "to her" mostly.  She
had continuous external fetal monitoring for the hour she was at the
hospital before he was out.  This had been a very difficult pregnancy with a
partial placental abruption at one point and a lot of bleeding, she was on
bedrest until the end, so the EFM was something she would have done anyhow.
She did have an IV but no pitocin, just fluids.  She had an episiotomy.
Stage 2 was only 4 minutes long, he was bulb suctioned as he came out in the
nose and mouth but no deep suctioning like her older son had had (he had
meconium aspiration and spent a few days in the NICU).  Bulb suctioning is
standard protocol at the hospital she was at; every baby gets it.  :-(  She
pushed side-lying with her raising her upper body with every push to let
gravity help.  Baby descended and rotated normally from posterior to
anterior, came out face down (OA) as normal.  Apgars were 8 and 9 and she BF
in the delivery room for 40 min.

A few nurses commented on how often and how long he was nursing; one
suggested giving him formula to tide him over, but she didn't start that
until day 3 when at home, with the SNS.  He would nurse 1/2 an hour on one
side, then 15-20 min. on the other.  The discharge ped and several nurses
thought he wasn't getting enough and was fussy.  But he wasn't overly fussy
when with her, only when not with her...the fussiness she is seeing now
started at 10 days old, coinciding with the engorgement being gone.
Everyone who has seen the latch says it looks fine, and it doesn't hurt, but
the football position on the right is a tad more than annoying she
says...thinks she has thrush there too which won't help matters.  She's
treating it though (as well as treating him).

She's heard various theories from people she's spoken with:

LC from hospital: it's normal for babies to need topped off between
feeds.

She can deal with that but wonders why the screaming DURING feeds.

LC from WIC: baby probably has a higher suck need and while he
comes off the breast on his own, he still wants to just suck, but doesn't
want the milk.

One ped suggested babywise (which she will NOT do...she is saddened because
he was a good ped for her older son who was bottle-fed EBM, but she knows
his suggestions could jeopardize supply particularily at night.

And another ped suggested colic and might be a bit of reflux and the baby
thinks it's the end of the world and is inconsolable.

What puzzles her is her *older son* had reflux and while he screamed from
that and the colic, he was generally happy to eat, especially when they got
a haberman feeder and the time it took him to eat went down dramatically (he
was quite traumetized from the deep suctioning she said and they had a hard
time feeding him for a while to begin with).

She's scared that something is going to happen because of the way he feeds
and she'll lose her milk and he won't gain.  She's pumping after "bad" feeds
to keep her supply but depsite EPing with her older son, she's not
responding to the pump the same way.  I told her maybe she shoudl try hand
expression this time around...if she's responding to the baby not the pump,
that's not necessarily a "bad" thing at the moment.  ;-)

She extracts a bit of milk before feeds to soften the areola and uses
compression after letdown but not during letdown for fear of him coming off.

sorry for the length of this post, I just wanted to be exact in the
information!

Fio
BF volunteer with Allaitement Québec
Mama to Sandrine (6yo and weaned!) and Nyssa (3.5 and almost weaned!)

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