In a message dated 1.26.02 9:51:11 AM, Pat writes:

>Dear Fio, if pooping volume is good, I would still stand by # of wet diapers
>per day of age (4 days- 4 pees) I wouldn't expect 6 good wet ones until
>day
>7-8 from this baby because of the slow, mixed up start.  Yes, I'd want
>to
>see poop color starting to change, but I'd anticipate a 2-3 delay in whole
>process because of the slow start.  As long as weight stops dropping and
>starts to go up (probably slower than what we usually see) and baby looks
>good, poops good, I think you're OK to watch and wait.  Separating mom
>and
>baby really has serious implications and nobody sees that but us!!!!
>Sincerely, Pat in SNJ
>
    Sorry for the premature send on the last post!
Fio,
I would emphatically *second* what Pat writes above .....and all of the other
replies to you as well!
In addition I would like to reemphasize the need for evaluation of fdng
effectiveness. You don't really mention this in your post. Does the baby
appear to be gulping with every swallow? does the swallowing frequency
increase with compression?
would the mother characterize the feeding as having changed a great deal from
her pre "milk in" fds? does she even know what to look for?
The clinical scenario that you present sounds very much like the baby became
borderline dehydrated d/t phototx and possibly ineffective feeding. At the
time of the visit and despite having been "recently" taking larger volumes of
milk, the baby had yet to finish replenishing the body tissues with the
missing fluids  (this is done prior to the kidneys receiving extra fluid to
process into urine or the GI tract into stool). The fact that the stools seem
to be changing (transitional) suggests that this is well on its way, however
AND this seems to coincide fairly well with the milk having become more
abundant over the past 24 hrs. or so.
Lynn Shea Rn,Bsn,Ibclc
Franklin,Massachusetts

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