Good evening to all of you~
I have a situation that I hope someone else has encountered and can advise
about, but I do not see anything in the archives.
I have permission from the mom involved to ask for input.
I saw a 6 week old baby today for a lactation assessment. His birth weight
was 2295 gms ( 5 lbs. 0.9 oz.) and today he weighed 2664 gms ( 5 lbs. 14
oz) According to the mother, he is breastfeeding about 8 times a day. He
looks really, really scrawny although alert and well hydrated. Mom reports
that he has at least 6 wets and 6 yellow, seedy stools a day. I did not see
any output while he was there.
He nursed eagerly for about 35 minutes total, on both breasts, and
transferred 2 ounces. Mom allowed him to end the feeding, after which he
was quietly alert. I know that this is not a great deal of milk, but he did
appear content and mom felt that she still had milk in her breasts. She did
not bring her pump, so we could not actually assess that. Mom had been
nursing on one side per feeding, but for the past week has made sure that
he nursed on both sides, every feeding. She feels that her milk supply has
not changed dramatically since nursing on both sides. She has pumped
occasionally, but not consistantly. She reported getting about 3 ounces
when pumping.
My question relates to her own health. She has had a colectomy--removal of
her colon. She is slender, but seems well nourished. We wondered if there
is any correlation between her own digestive situation and the fact that
her baby is gaining weight so slowly. I doubt it, but said that I would
research it.
The plan at this point in time is to give the baby more calories. After
discussing a couple of options, the mom chose to supplement with 22Kcal.
formula after nursing. She will continue to nurse "on cue" or at least 8
times a day. She did not feel up to trying to increase her supply with
extra pumpings, and fortifying that milk or skimming off the creamy milk
and supplementing with that.
The pediatrician is very, very supportive of breastfeeding. But, she is
understandably concerned. This baby really looks malnourished! If the baby
does not begin to gain weight at a more "normal" rate after getting the
extra food and calories, she will look for other reasons for his slow
weight gain.
I also thought about recommending fenugreek, but hesitated, wondering if
there would be any problems for her with her limited digestive system.
Any thoughts? ideas? suggestions?
The baby will be coming back in a week to reassess his weight and intake at
breast.
Thanks
Kirsten in Wisconsin
***********************************************
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html
|
