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Date: | Fri, 18 Mar 2005 20:46:17 -0600 |
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Regarding the pediatrician who recommended apple juice for the 3 week old
baby who wasn't pooping. Zena, this is where the HCP report of the lactation
consultation is a great help. When IBCLCs send a report to both the pedi and
OB, they can mention their observations and include relevant technical
information to help train these doctors. I have had two WIC clients using
the same pedi, both with babies that we at WIC think are way under weight
(pedi said they were ok). I wrote up a HCP report and mentioned that we had
told the mom(s) that normal weight gain for a BF baby is 6-8 ounces per week
and by this standard "WIC was very concerned about the lack of weight gain",
etc. I am hoping he is learning something and coming to realize he can rely
on WIC. Our offices are within walking distance. This is also where careful
phrasing comes in.
I would not say anything about the apple juice, rather that your concerns
are the poor intake, evidenced by your test weights and by the lack of bowel
movements. Be careful assuming that what mom thinks she heard is what the
doctor actually said. Sometimes moms get things a bit backwards.
Some women who have not gotten off to a good breastfeeding start are able to
recover and establish a full milk supply later. Others are not. This mom
needs to give it a good two weeks of intensive work, hopefully she can do
some pumping on a hospital quality or rental pump 4 times a day after
nursing. The most important thing is to increase the amount of calories baby
is consuming and hopefully also the time baby spends at the breast. Babies
that are under birth weight often do not suck vigorously until they fatten
up some. Make sure she is feeding baby plenty, at least 2.5 ounces of
formula or breast milk times what his weight should be at this point, not
his current weight. He may need several more additional ounces per day.
From what you describe as baby's feeding behavior, the problem may also be
on his part. These are really tough ones to solve.
Good luck, Kathy Eng, IBCLC
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