(Permission to post.)
I spoke with a mother yesterday. She claimed nipple confusion, severe
colic, refusal to latch, low milk supply. I discussed any problems with
pregnancy (none, to her admission) and after almost a half an hour of
taking a history, she added, as an afterthought, the fact that she had a
gastric bypass about a year before she got pregnant. Child was SGA and had
ABO incompatibility. (Lost 160 lbs!) She only gained 10 lbs during her
pregnancy, and says the OB didn't see this as a problem. (????)
NO ONE discussed breastfeeding with her before or after the surgery (and
she claims she and her husband had planned a pregnancy as soon as she had
lost the weight.) She is not seeing a nutritionist or a dietition. She
lives on 250 to at most 500 Cals a day, most of it Dairy products (gee,
colic anyone.) Seemed surprised that her malnourished body was having a
hard time making milk due to her low food intake, total lack of carbs and
fat in the diet. Is pumping 8 times a day, with no increase. Only one oz or
less per pumping. I have not yet seen them, as she wants to now see the
hospital LC (who expressed little discomfort with this situation or her
nutritional status.) Her doctor gave her a "consultation" which consisted
of forcing the baby to the breast and leaving him there "until he takes
it." This child and mother are miserable.
WHERE was the follow up for this mother and her baby? I'm livid that such a
radical procedure is being taken so casually by her HCPs.
I suggested she 1)See a nutritionist or dietition, so she can make every
calorie count, without ODing on dairy products 2)DO NOT force baby to take
the breast, 3)have a consultation, to discuss cup feeding, milk increasing
ect.strategies to teach baby how to nurse without force, ect.
Any info on gastric bypass and lack of follow up for these women would be
appreciated.
Mary Jozwiak IBCLC, RLC, LLLL, AAPL
Private Practice
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