Maybe someone can shed light onto this case for me. I have mom's permission
to post.
I made a home visit to this mom just to make sure everything was alright at
2 weeks. She had also taken my prenatal class and everything was going
well. Baby was born at 3.300 naturally, and had gained beautifully. She
was already 200 grams over birth weight and eating well. I had nothing to
suggest, and just encouraged her that all was fine.
At 4 weeks, the mom called that she was sure the baby had reflux. She had
begun to be very fussy at breast, sometimes refusing to eat, and had been
spitting up tons. She also did not gain any weight from week 4-5. She
began Zantac, and things almost immediately improved. The spitting up
stopped, and baby was happy and calm at breast. This continued for about 2
1/2 weeks. Now, the past week, baby has been often miserable at breast.
She begins to eat, then fusses, pulls, turns, and eventually unlatches and
then refuses to go back on. The feed that I observed, in this time she had
eaten 22 cc, and that was it. After that, the mom pumped and she took
another 60cc happily from the bottle. Sometimes a feed will go better, but
it is totally random, and most feeds are miserable. It does not seem
allergy related because she takes the milk by bottle with no problem. I do
not suspect that it is flow related. Breast compressions did not alter the
situation, and there is plenty of milk available. She also has only gained
about 100 grams in the past 3 weeks.
Help! I cannot figure out what is going on. The mom also says that the
times she does do a total pumped milk feed, although it goes smoother, she
never eats a very large amount-usually only 80 cc ( which at this point you
would think she would be eating closer to 120...I know numbers don't make a
difference if she was gaining well, fine, but don't forget she is not
gaining well. ) By the way, she checked back with the Gastro, who insists
that the zantac dose is correct and does not need to be adjusted.
Anyone have any ideas? This mother is desperate to nurse and have things go
well, and I just don't know what to tell her.
Thank you,
Please email me privately as well as to the List.
Jessica Billowitz, IBCLC
Israel
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