HI Ladies,

Very perplexing case today. A one month old male child seen in ER for poor 
feeding a low urinary output.  Baby born by CD with initial latch problems. 
Infant has a shelved, anterior palate and fair tongue excursion. With crying 
baby has tongue curl and retraction. Birth weight was 8-2 and dropped down 
15% early on which was recovered by 2 weeks of age with pumping and 
supplementing with 95% expressed milk. Mom felt things were fine at home 
until about a week ago

Last night in ER baby was noted to be 7-5 and immediately took 2 ounces of 
expressed milk by bottle. mom claims to be unable to feed the baby at home, 
even though he is  very fussy. Temp was 99.7.  This poor guy is so 
dehydrated and the yet the test weight in the office was noted as a2.1 ounce 
intake a regular feeding. . Mom feels this baby is "sick" and doesn't like 
to eat. She told the doctors in the ER the baby only feeds q 6 hours. To me 
he is very capable. Mom denies, depression, seems to care for her baby, but 
is very quick to use a pacifier.

Maternal anatomy is WNL, and she denies birth control, and she is  looks 
well nourished.

What would keep a one month old baby from eating. I'm wondering if this baby 
is ill? The stools are avacado green according to mom.  I'm anxious to 
return to work to see what tomorrow brings as this little guy was admitted 
for observation.

LuAnn Smith RN,BSN,IBCLC

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