After a note from a colleague I figured I'd better put a couple
clarifications to my head banging post.

 

First:  I am glad that the Dr/NP saw there was a potential issue.  But,
parents report that it was a very relaxed attitude.  There was no math done
to see the scope of the problem.  Here are some more details (copied from
the note I sent back :-) ):

 

Baby is 4 months old - born on 11-06-07.  She was 5.14.5 oz on 11-10 when I
saw her.  From 11-10/1-9-08 she gained 60 ounces (in 60 days) that's 1 ounce
per day average.  From 1-9-08/2-19-08 she gained 18 ounces (in 41 days) this
is .44 oz per day average.  From 2-19-08/3-11-08 (21 days) she only gained
3.5 ounces.  Clearly one can see we have a baby failing to thrive.  She may
be happy - but she isn't thriving.  (unless I am wrong about what FTT is.)

 

I did tell the parents that I was glad the Dr/NP recognized there may be an
issue when they so often miss it completely - however, I did wish that they
had taken the time to do the math.  The last Dr visit was 3-11.  It was 10
days past that when mom finally contacted me.intervention of more than just
fenugreek should have been really looked at on the 11th.

 

I will get a report from mom tonight on the baby's milk intake at breast.
It may be possible that there was one of those 'baby living on let down the
first 2 months' scenarios happening.but I don't know.  I just know that,
while I am glad the HCP noticed that there was an issue I am frustrated
because this is not the first time no one did the math to see how serious an
issue it was. 

 

I actually have another baby from another Ped (who is usually very good) who
dismissed my report to him with my documentation of the numbers (mom gave me
a listing of all the weight checks she had done of this baby on my scale <at
mommy group> and Dr's scale over a 5 month time period) clearly documenting
serious weight gain issues from 2-7 months.  This baby is now, at 12 months,
seriously delayed in growth, physical and cognitive developmental
milestones, etc.  I clearly documented she was FTT in a big way.  Baby had
actually been not gaining and or losing weight at various times.  He
dismissed it!  He told mom not to worry.BF babies grow differently.Mom had
serious hormonal issues - he knew and dismissed that too as any possible
reason the baby might be having issues.  (mom had never seen me for a
consult - just called in repeatedly with questions and concerns.  I had
always told her she needed a consult and that I felt the baby probably
needed supplementation - she didn't want to hear it and would say "But Dr.
told me XXX". )  She finally recognized that there 'may' be an issue and
asked that I do the weight comparisons.when she saw the numbers she freaked.
She started supplementing immediately - finally.  Baby is gaining, but still
has a lot of catch up to do.and mom just doesn't understand why she is so
behind.

 

There are times when being BF friendly is a good thing - and times when I
have seen it to be too much of a good thing and problems are missed based on
'BF babies grow differently'.  Where did that middle ground go???

 

Jaye Simpson, IBCLC, CIIM

Breastfeeding Network

Sacramento, CA

www.breastfeedingnetwork.net

 


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