Hi Lactnetters,

 

This is puzzling to me and I’d love to get feedback. I have permission to
post. Mom gave birth to 1st baby on 8/15 to a 9lb.15oz boy after 18 hours of
active labor w/ no epidural and 35 hours since her water broke. Mom had no
epidural but she did get IV antibiotics and fluid. Baby was 39 ½ weeks no
diabetes or blood sugar issues and according to her big babies run in the
family, both she and her brother were over 9 lbs. Baby was discharged from
the hospital at 9lbs. 6oz. and peds wasn’t worried. 

 

Mom called me on day 9 and I saw her on day 10. Baby had got down to 9lbs. 2
oz. and had crystals in urine and no poops for a few days. I got her set up
with an SNS and a schedule to supplement with the goal of getting 25 oz,.per
day by SNS, cup or bottle. She called me back on day 12, said she had gotten
in 18.5 oz. the last 24 hours and was pumping up to 4 oz. at a time. Baby
was starting to perk up a bit but still needed to be motivated to get to
breast. When she went back to the ped the next time he was pleased that the
baby went up to 9lbs. 6oz. and plenty of pale yellow or clear urine although
the baby still wasn’t pooping very much. He weighed the baby before and
after a feed with a non digital scale and figured the baby took about 2 oz.

 

Baby slowly started to gain and she reduced supplementing a bit. Baby went
to 9lbs. 9oz. last week but this week dropped down to 9lbs. 7 oz. Mom
reports that this past week baby was spitting up massive amounts in the
morning several mornings in a row after sleeping for a few hours and she
kept putting the baby back on and the baby did this three times one morning.
Ped is now concerned and has set up a GI appointment. My intuition is
telling me that there is an overactive letdown even though baby has not
gained back to birth weight and I wanted to know if anyone has run into
anything like that before. Am I crazy to think such a thing? 

 

Any other ideas or suggestions would be so welcome. Mom is so sweet, so
lovely and so worried that things have not resolved yet. I really am
encouraged by the amount of milk she pumps and have continued to encourage
her to pump, supplement and feed frequently but she is discouraged about
having to step up supplementing again. Thanks so much for your help in
advance!

 

Barbara Holmes RD, IBCLC

Brooklyn, NY

 

 

 

 


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