Hi All,

From those who personally replied to the mom with 70% pituitary removal. She
did stop nursing with no signs of milk at day 4 post partum, no subsequent
signs of milk "coming in". After the peds stated it was "ok" to let a 11%
weight loss continue without supplementation, the following day (I was off)
he told her she really needed to bottle feed since her milk was probably not
going to come in. The LC on that day said the mom promptly and with relief
gave in to this advice and was not receptive to continued work. :(

OTOH, the effects of the WTC catastrophe continue. Today I had a Dr.
referred 2 week old 37 week AGA infant in my office with a birth weght from
7-5.7 to 6-5.1 today.  This poor little fellow was vey thin with a large
head and very thin body, obviously calorie deprived. Mom a gr 3, nursed 2
other children without incident and last baby a particulary "good nurser".
Both of these births occured without augmentation or induction. This baby is
jaundiced with microbili of 15 yesteday. CBC and other electrolytes WNL per
Peds.
Baby had unusually wide and anteriorly placed shelved palate. Mom with
fairly large, almost 1" sized nipples. Mom was augmented after 12 hrs of
prodromal labor. Here is the clincher: mom went into prodromal labor after
hearing that her husbands brother was missing in the WTC crisis. They did
not hear until late Tuesday evening that he was safe. Admits to being quite
stressed and fearful. She labored well into Wednesday morning and then
received pitocin to augment her stalled labor.  This little man sluggishly
nursed in the hospital and at 2 weeks acts like he is too tired to nurse.

We corrected a somewhat shallow latch - mom thinks this may have been an
issue at times. With an excellent feed he received 2.6 oz ac/pc. He is
voiding and stooling well, but mom stated that his stool is sometimes frothy
as opposed to yellow seedy. She takes allegra and sudafed regularly for
chronic sinusitis/seasonal allergies. She denies food allergies in
herself/siblings of the baby. Her hubby is an internal medicine hospitalist
and she is very educated as well, and a stay at home mom.

Stress????Meds?????Poor latch???? Malabsorption????or a combination????
We are working to increase caloric intake at the breast and she is coming
back in a few days. This was just such an interesting "scratch your head
kind of case". Wanted to share ....Comments are welcome and I'll keep you
posted if you like.

LuAnn in PA - some 3 1/2 hours away from NYC but feeling much closer today!






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