Hi all,
I'd really appreciate some suggestions for this mom & baby...
35yo g3,p3 -- 8 wk old boy, vaginal delivery, no complications
Mother slightly hyperthyroid (was hypothyroid, meds adjusted after delivery
and are being adjusted down now).
According to MD, pituitary is normal & normal prolactin levels.
Mother has had two rounds of Reglan and has been taking Fenugreek.
Baby wasn't gaining enough weight -- 4 oz in 2 weeks and it was assumed that
production wasn't enough.
Mother has been pumping with PIS. 3 weeks ago started using SNS, but states
that even with largest tube, baby doesn't take supplement -- she states it's
"too hard" for baby to get.
Feedings are becoming an ordeal. Breastfeed x 40 minutes, pump x 15min and
bottle feed x 20 minutes and start the whole thing over again a few hours
later.
Baby doesn't seem hungry. Falls asleep at breast after only a few minutes.
Mother uses compression (and uses it well). I was skeptical myself about
what she was telling me, but actually saw a feeding and nothing we could do
would keep this child awake to breastfeed. It was like a switch was flipped
as soon as he 'hooked up'. However, he did transfer approx 26ml in that few
minutes. Mom proceeded to burp, wake, and put back to breast at least 5
times, using compression the whole time and he transferred a total of 2
ounces in 45 minutes of off and on, off and on. Mom is able to pump approx
1 1/2 ounces after feeds, and since for his weight he should be getting a
little over 24 ounces per 24h, I don't think she has a production problem.
He plays around with the bottle too, falling asleep as well. I saw this
baby last the day after a ped appointment and he was given a clean bill of
health except for his weight gain. He appears 'normal' whatever that is,
but I've not had experience with babies who don't seem to want to eat.
Other than hang in there, I'm at a loss as to what to suggest.
Anyway, Mom is just about at wit's end -- she has a 4 year old as well and
he is a typical 4 year old, so she has a challenge there juggling baby and
pre-schooler.
Does anyone have any suggestions I can relay to her? She is a real trooper
about this, has been in twice for outpatient visits... she really wants this
to work -- 4 year old weaned at 6 weeks because she 'didn't have enough
milk'. She's not just looking for permission to quit.
Thanks in advance,
Cindi Swisher, RN, IBCLC
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