Jay Gordon wrote:
This baby was delivered at term by CS for FTP and has a resp rate of 60 at
the breast and 70-90 when not at the breast....Am I wrong about BFing with an
RR of 70+??
Jay,
You said that oxygenation was good, and it seems the baby is more tachy off
breast than on, are they "allowing" bottlefeeding? If O2 saturattion level is
good, and baby is relaxed, wouldn't that be the important thingt? If the baby
was truly failure to progress, and I guess some are ( not just arbitrarily
"ran out of time to be born"), is there anything else going on which would
explain the rapid breathing? I keep in mind something an MD once said: "The health
baby helps him/herself born." Many babies don't get that chance with so much
augementation and management, did this baby get the chance and then demonstrate
that he couldn't help? Is this the baby's current "norm" for some reason and
breastfeeding would be at least physiological and less stressful than
bottlefeeds? Was the baby kangaroo-d, nursing at breast skin-to-skin with mom, when
the RR was measured?
Here is something I found just now...
" RR of 30-50 is 'normal' for 0-1 month old. ...
REMEMBER:
The patient's normal range should always be taken into consideration.
Heart rate, BP & respiratory rate are expected to increase during times of
fever or stress.
Respiratory rate on infants should be counted for a full 60 seconds.
In a clinically decompensating child, the blood pressure will be the last to
change. Just because your pediatric patient's BP is normal, don't assume that
your patient is "stable".
Bradycardia in children is an ominous sign, usually a result of hypoxia. Act
quickly, as this child is extremely critical. "
Just musing,
Judy LeVan Fram, PT, IBCLC, Brooklyn, USA
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