I would ask the question "was the birth weight correct?" I have had the
experience of an incorrect weight being recorded which lead to undue anxiety
about the supposed dramatic weight loss of a new born infant. Also, if the
weight loss was indeed more than 10% you would see quite dramatic signs in
the baby of dehydration.
Some c/s babies are born quite "water logged", (especially if one or two
weeks early) and have a massive diuresis several days after the birth.
I'm sure by now the mum's milk is rolling in but I doubt whether you would
consistently get the volume you mention with test weighing which is only
going to set up more anxiety.
What about trying breast compression during a feed and looking for those
long deep draws.
Here in New Zealand we do not weigh healthy babies again until one week of
age unless their is a clinical indication to do so, e.g. premmie, obvious
signs of inadequate feeding etc. I guess we are lucky that as midwives we
can follow babies through at home until 6 weeks of age so there isn't the
pressure to "fix things" before hospital discharge.
Good luck.
Karen Palmer
Midwife----- Original Message -----
From: "JOKR PANZER" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Friday, February 11, 2005 7:37 AM
Subject: pre and post feed weighs
> Would pre/post feed weighs be appropriate in the following situation:
with
> day 3 infant weight loss approaching 10% and mothers milk not yet in
> physician ordered supplement after breastfeeds, volume not specified. At 3
> days 12 hrs (about midnight) mother noticed significant breast changes,
d/c
> supp and fed through night, at morning weigh noted baby continued to lose,
> now>10%. Physician ordered to continue to offer supplement post
breastfeed.
> Upon observation baby latches well, normal suck, visible audible signs of
> milk transfer. Her nurse and I are exploring alternatives together to
> discuss with physician.
> -Do nothing, observe/assist with effective breastfeeds, reassess at
midnight
> weight check. Obviously, the physician has a concern with this approach...
> -Have mother pump and offer expressed breastmilk after breastfeeds. The
> nurse's concern here is maternal exhaustion and overwhelming this mother
who
> is post c-sec.
> -Offer formula supplement post breastfeed. My concern is overwhelming baby
> with too much volume thereby delaying next breastfeed, impacting maternal
> supply, as well as possible risks to baby of artificial milk. As you may
> imagine nurse thinks I am overstating what is only a marginal, theoretical
> concern......
> -What about test weights? Nurse fears that if we don't get the volume we
are
> looking for (about 1.5 oz ballpark) we send a powerful, negative
> psychological message to mother....she may very well be right. On the
other
> hand if there was good transfer we could d/c supplement and the bother of
> expressing.
> thank you in advance for your help-
> Kristen Panzer MS IBCLC
>
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