Michelle,
PLEASE urge mom to supplement this baby! With his poor weight gain to date, he will not have the energy to stimulate her milk supply and he will continue in this viscous cycle. Do not hesitate to give him what he needs right now, (CALORIES) by whatever means is easiest and comfortable for mom. She can allow him to go to breast too, but this time should be limited so he doesn't use up a lot of energy just hanging out there.
Have mom continue to do brief pumps and use whatever milk she gets as supplement. She may need to temporarily use some formula to get him over the hump too.
Once he is at expected weight, he can be expected to do better and better at the breast. He will be a different baby!
Good luck. Keep us all informed.
Mary Griffin Kellogg, MD, IBCLC
Breastfeeding Resources
Stratford, CT
---- Michelle Beers <[log in to unmask]> wrote:
> Hello. I'm needing help with a patient and welcome your wisdom! I have
>
> permission to post.
>
> This mom delivered on 2/20/06, second child, uncomplicated pregnancy and
>
> delivery. Birth weight 7# 4 oz. Discharge weight at 48 hours 6# 11 oz.
>
> 2 days later at her home visit infant weight was 6-10, the following day
>
> weight remained the same. On day 9 infant weighed 6-11.7 (pre-feeding)
>
> and 6-12.2 (after nursing for 15 mins on one side) Infant then nursed fo
> r
> 5 mins on other side and weight went to 6-12.3. Mom has to continually
>
> stimulate infant while she is at the breast to keep her actively
> suckling. Infant latch appears to be good although mom does have rather
>
> large nipples. Mom pumped after pre and post wt. and got 1 oz from each
>
> side (used Lactina). Mom encouraged to continue to nurse infant 8-12
> times every 24 hours. Mom stated she had been pumping with manual pump a
> t
> home occasionally and was giving 1/2 oz of breastmilk per dropper 1-2
> times per day.
>
> I spoke with mom on day 11 and she said that infant was nursing better
>
> (staying awake more) but she continued to give 1/2 oz by dropper 2 times
>
> per day. Pt stated she felt that her infant was gaining wt. and had a
>
> weight check the following Monday. Today infant went for weight check,
>
> infant is 2 weeks old, and weight was 6# 6 oz. Mom is beside herself and
>
> states this same thing happened with her son. Her ped recommended
> supplementing formula 2 times per day, starting with 2 oz. per feeding.
>
> Mom is questioning if her milk is "bad". We discussed using a SNS, mom
>
> asked about continuing to use the dropper, and discussed using pumped
> breastmilk vs. formula. Infant is having 6+ wet diapers per day but
> stools are infrequent and are brown/mucousy. I welcome any input, and
>
> apologize in advance if I've been too vague with details!
> Thank you for your advice and support,
> Michelle
>
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