Sounds like you're getting enough nutrition for weight gain, now I'd
worry about what could be wrong with baby.
is the baby neurologicaly normal?? were the neonatal labs ok?  is she
hypo thyroid?  was it a tough birth, could there have been an intra
cranial bleed??  Is there a STRONG fam Hx o food allergy?
keep us posted
grace (pediatrician)

> -----Original Message-----
> From: Denise Mollenkopf, RNC, IBCLC [SMTP:[log in to unmask]]
> Sent: Sunday, October 05, 1997 9:45 PM
> To:   [log in to unmask]
> Subject:      slow weight gain-input please?
>
> Hi friends :)
> I'd like your feedback on this one...
> I have a client with a 4 1/2 week old girl who was referred to me by
> the ped.
> for poor BFand wt. loss.  I saw her first at 2 weeks of age, with fair
> latch
> (only mild nipple tenderness), good suck strength, a somewhat
> posterior
> tongue, but not severely so, but a placid, sleepy baby.  She would
> nurse only
> 5-10" at a time.  Mom has nursed two others successfully, and is very
> diligent-was pumping additionally to increase supply.  We initially
> worked on
> mouth exercises (that helped suck coordination), nursing one
> breast/feeding,
> and supplemented over one weekend (peds orders also due to weight
> loss).  The
> supplementation was then cut back to just once or twice/day-she was
> having no
> stools and just barely held her weight that week. We increased
> supplementation and she gained weight that week, was having good urine
> output-and a few stools.  I started mom with a supplementer at breast,
> as she
> was getting discouraged and worried. Ped agreed.  She is putting an
> ounce in
> the supp. each feed.  We have had to use the large tubing to get her
> to take
> 3/4 to 1 ounce/feed.  Mom seems to have good supply-can pump several
> ounces
> at a time easily, has good MER.  At breast, WHEN she sucks well, there
> is
> audible swallowing.  Baby has had more than a pound gain in last two
> weeks-I
> keep expecting a turnaround in energy/suck-she is still a very sleepy
> baby
> requiring marathon efforts by mom/dad to wake her to feed.   She has
> more
> awake/alert periods, but even with the supp. sucks effectively for at
> the
> most 20 minutes.  Mouth anatomy feels normal, suck coordination much
> better
> now.  This mom is tiring out.  She is well educated, very compliant.
> She is
> also 41 years old. We will do a weight check again tomorrow or
> Tuesday.
> Any suggestions fellow LCs???  Thanks in advance!
>
> Denise Mollenkopf
> Florida