i missed the original story but wanted to share that today i had a consult 
in which the dyad had done very little breastfeeding yet and the baby is now 
11 days old.
i was not in the office last week due to my father's end stage illness and 
death. (cancer). there is no other LC there so the nurses covered as best 
they could. i called back the moms that i had missed and all were doing 
well, thankfully, except one. she was able to see me the next day (today). 
she stated she had bf only about 10x in these 11 days and pumped only 2x. 
she did not get anything w/ the pump so discontinued. she said she did not 
get any help in the hosp. she did go thru lactogenesis II with very full and 
leaking breasts the first week.

today, she had very soft breasts but milk expressed easily with good squirts 
w/ hand expression. the baby latched very eagerly altho positioning was very 
poor and latch was shallow. we corrected that and baby consumed 50cc at 
breast w/ breast compression.

the birthwt was 7#2, the d/c wt was 6#11 and the baby weighed 6#14 on 1/14 
in peds office with a diaper and tee shirt on (caution: weigh new babies 
naked). today baby wt is 6#6 nude. so baby is still losing wt. it was very 
obvious that pacifier was used frequently and when questioned parents report 
that is so. baby was taking 2-4 oz formula but fed infrequently.
plan is to d/c pacifier, bf ad lib, keep feeding diary and diaper diary, 
shoot for 10+ feeds in 24 hrs. wake baby if necessary, but probably not 
necessary since parents had not been responding to cues of hand sucking etc. 
post feed pumping whenever possible - they have a 5 yo too.  (trying to get 
a pump from WIC program). her evenflow manual pump did absolutely nothing to 
get the milk out. i advised hand expression if not able to get a decent 
pump. reweigh on my scale (medela baby weigh) on 1/21. report sent to MD.

i have alot of hope for this dyad.


Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA

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