I have a question related to breastfeeding and effects of IUGR;  mom
delivered her breech infant by C-sec at 37 wks gestation, due to inadequate
amniotic fluid and was told "baby wasn't gowing last 2 weeks of gestation."
Baby was 5 lb, 11 oz DOB.  I saw her at day 13, due to poor wt gain, 1 oz in
a week, probably due to mom trying to BF only for 3 days prior to HV, without
supplementation as she had been doing by finger feed and bottle.  Baby is now
back to gaining WNL, over an oz/day with renewed supplementation of EBM
(expressed breastmilk).  My question regards her neurological and physical
development and need for neurodevelopmental evaluation.  I would expect that
her stunted intrauterine growth affects her neurological development-is this
correct?  Would then she be considered a 35 weeker?

In my rather limited experience with premies she appears SMG (small for
gestational age) as well.  She has a weak suck but able to transfer milk,
with help-breast compression, stimulation to continue feeding-with nipple
shield' an oz in about 30 min., she's then supplemented another oz on average
(am going to institue use of SNS if mom willing).  So, any feedback on
working with her is appreciated.  I find I'm often more concerned re
devolpment than Peds as way back when I worked in children's rehab it was
impressed upon me that early is better as far as intervention and eval and
I'd like to inform this mom of this but don't want to cause unnecessary
alarm.  This little one just seems rather "zoned", no eye contact even when
alert.

Hope this isn't too jumbled; I'll give further details if needed.  Thanks!

Barbara Latterner, BSN, RN, IBCLC
Brewster, NY

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