I realize we've about beaten the issue of test weights to death, but I want
to share two brief, but illustrative case studies where test weights
recently helped me help families. In preface, I want to affirm what Jack
said: both mothers were depressed when the results of the weights confirmed
poor feeding. However, both were in serious denial about their baby's
situation, and the reality check helped them make better decisions. I got
depressed when my doctor told me I have reflux. I hate bad news. But the
information mobilized me to make healthy changes. So while I always try to
shore up the confidence and faith of the mothers I serve, I'm not sure
keeping bad news from them is in anyone's best interest.
Baby #1 born at term with a complete cleft of the nose, lip, and palate.
Sent home latching well and making swallowing sounds -- everyone thrilled
that baby was breastfeeding. I saw on Day 4. Weight already down >10%
birth weight, and jaundiced. Helped latch, improved positioning, taught
breast compression and observed. Looked like a great feed: eyes open, lots
of sounds of swallowing. Test weight indicated baby actually used up 2 g
feeding. Second breast, intake put baby back up to zero. If this had gone
on longer, mom's vital milk supply might have been very compromised, and
baby would have been at risk. By knowing that what we were hearing was not
actually the baby taking in milk we were able to start pumping, bottle
feeding with Haberman, and baby stabilized. I put them in touch with Dr.
Denk in VA who does the early repairs, and baby had nose and lip repaired on
Day 17 of life. Baby was able to have the surgery because he was healthy
and gaining. He will go back for the palate at 2 mo. and because mom is
pumping and protecting milk supply, should be able to breastfeed when this
is all over.
Baby # 2. 5 weeks old and 7 oz below birth weigh. Mom very dedicated.
Nursed round the clock for 5 weeks trying to get weight on baby and in
extreme denial about baby's lack of ability to transfer milk until this was
documented by test weights. This info helped her decide to pump, take
domperidone, and start supplemention. Baby gained 6 oz first 24 hrs, 5 oz
second 24 hrs, and seeing this recovery, the tests the pedi had ordered to
rule out CF and other organic causes were cancelled. Her milk supply is
coming up, and she uses the scale on a daily basis to help decide how much
supplement she needs. We are now tapering, and my hope is she will recover
enough of her own milk to return to exclusive bfeeding.
Barbara Wilson-Clay BSEd, IBCLC
Austin Lactation Associates
http://www.lactnews.com
***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html
|
