Kristen
The pre/post weights would be useful I think. The infant can appear to be
transferring milk, as well he likely is, but what amount is he actually
transferring? Visual estimates by moms or LCs are inaccurate. "Test" weights
on a digital scale +/- 2 gms will tell you if he's taking in 3cc or 30cc. If
he is taking very little, but mother now has a substantial supply, then help
him bf more effectively but also have mom express and give to him. If mom
does not have as much milk as baby needs, then a donor milk or formula will
be needed.
If he is taking in adequate quantiities at breast, then perhaps mom just had
a delay in her milk increasing or he was feeding infrequently or
ineffectively in the beginning.
In a case like this, I think that "insurance expressing" or expressing after
milk left after a breastfeed to use as a supplement at a later, possibly
ineffective feed, is helpful. I think it helps boost mom's supply and sort
of makes up for the slow start in the first days.
The method of supplementation is up for debate, of course - anything from at
breast supply lines to cups to droppers to bottles.
Doing nothing I think is not a good idea as baby is doing a downward spiral
it seems.
Surely mom is tired and worried, however if she needs to pump I recommend
that she do a double pumping every 2-3 hours and sleep with baby in between.
Have a family member come in to help if possible to do the diapering etc and
feeding mom. If the baby is bf ineffectively, do not draw out the feeding
time too long, allow time for baby to take the supps and for mom to express.
Make sure this baby gets early and frequent followup w/ nude weights and
supporting mom for several weeks at least.
Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA
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