Valerie writes:  What has me mystified is the diapers counts.   This baby 
has 11 wet diaper=
s
and 6 BMs in 24 hours.  Stool is  normal, soft, yellow, curds.  Advised mo=
m
to have her thyroid  levels checked again.

Other ideas?  What have I missed?
 
Vqlerie, you state that baby is at 7 % weight loss at 9 days and is  having 
11 wet diapers and and 6 normal breast milk stools in 24 hr. and is  
nursing effectively with a nipple shield.  I'm not sure you've missed  anything. 
My guess is this baby probably lost greater than 7 % and is now  on a course 
of normal weight gain. I would re-check weight tomorrow to make sure  baby 
is gaining, and of course, weight needs to be checked on the same scale  
under the same conditions (naked weights are always my preference to track wt.  
gain).. When I start a mother on a nipple shield which I would have done in  
exactly the situation you describe I have her pump with a hospital grade  
pump after most feedings until baby is gaining and milk supply is  
sufficient. This is usually just short term but I want to assure that milk  supply is 
protected. Extra pumped milk is fed to the baby.
 
Let us know how things are going with this couplet. My guess is all is well 
 at this point but close follow up is the only way to tell.  
 
Kathy Boggs, RN, IBCLC  
 


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