Ann wrote:
Her weight remains in less
than 3rd percentile, her height is in the 25%, and her head circumference
is
50%. He was getting a urine specimen and blood test because the last urine
showed some metabolic problems but I do not know what. He tells the
parents
that they need to try other solids to see if they can get her to take more
food, continue her meds and have set them up to see a Metabolic specialist
in
early Jan.
She is getting more PT, at least twice a week now. I am encouraging the
breastfeeding since this is the only thing the baby is really able to do for
nourishment.
Just a few quick thoughts... the metabolic test results may indicate why
this baby is smelling oddly and gaining slowly. Depending on the situation there
may not be any use/success in getting the baby to take more solids, and the
tone issues may exacerbate fatigue or skill faltering at breast. Do we know
how much this baby gets at a nursing via digital scale? That would be good to
know. If the baby is getting adequate calories and not gaining that is a
different issue than a baby whose tone, coordination or energy levels do not allow
for efficient, adequately long feedings. If the baby can manage more
feedings, or manage more flow with pumped milk at breast, that might improve calorie
intake and weight gain, or at least optimize whatever this baby can do. It
would be good to attend a session or two with the PT as well. I did this with
a baby with tone issues ( I don't work as a PT now, usually) and was there
with my IBCLC hat on and we got to talk about what we were seeing and how we
were responding to help the baby, together.
I'm sure others may have helpful comments here...
Judy
Judy LeVan Fram, PT, IBCLC, LLLL, Brooklyn, NY, USA
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