You are right Heather we didn't need the pump test. When I got to her, the
doctor had ordered her to pump every 2 hrs. Of course the baby was
supplemented, the baby had some electrolyte and bilirubin elevations. I
guess a 4 hr test could have been ordered (no, I'm not going to tell them
about that but I'm not dead-set against it) and we could have extrapolated
her 24 hr intake and how much she needed to supplement. The baby gained
about 2 lbs in 4 days (he had an IV at first) with just ad lib
breast/bottle feeding. The mother got very sick of pumping and refused to
do it anymore. I think it was a very bad combination of oestrogen, mom
thinking baby should be sleeping longer stretches and not really worried
about few feeds per day, and UTI making baby feel bad and not asking to
feed perhaps. This would be a lovely time to use a nursing supplementer but
mom didn't want to.
If we wanted or needed to be very very precise about mom's production, I
can see the reason for this assessment tool, but agree we need more
discussion of it's value and need for studies to be replicated.
Laurie
Laurie Wheeler RN MN IBCLC

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