Hey everyone,

 

I need to vent and then have a question and need some input.

 

I don't get it.  First we deal with HCP's who jump the gun with
supplementing and interfere needlessly with BF,  and then I get a Ped (who
has routinely given out what I consider to be dangerous recommendations with
BF babies and has left 3 practices in the past 18 months <you don't even
want to know what several parents have told me re: the circs this one has
done.>) who tells a mom with a 12 day old that, while the weight is looking
like it may be a problem, let's start with pumping first 4-5 times per day
and try to get that supply up a bit.  No need to supplement with ABM just
yet - let's give it a few days, every other day weight checks and see what
happens.  Don't worry mom, I know you don't want to sup with ABM so we'll
use that as a last resort.  Let's protect that BF.  Sounds OK right?  

 

Well let's see:  Baby born at 7' 14", 41 weeks, emerg c-sec due to low fluid
level and mec in the waters, weighed in at 6'9" on day 12 (yes that is 21
ounces below BW!!), 3 wet diapers per 24 hours and is having one orange'ish
small stool every other day, nurses constantly, is fidgety and cranky all
the time, doesn't sleep much, constantly chewing on her hands.  Where is my
emoticon for tearing my hair out????  I done broke my brick wall and need to
get a new one!

 

But wait - it gets better!  Someone (don't know who) told mom about how
babies born to moms who get lots of IV fluids can be over hydrated and their
birth weight inflated.  They were told that this meant that their baby
didn't really weigh in at 7'14" - so not to worry because she just got rid
of all that extra fluid and that was why it seemed like she had lost so much
weight.  EXCEPT that:  Mom only had 7 hours of IV, 1 - 2 bags of fluid and
about 45 min of Pit.  No epidural - she had a spinal block placed minutes
before the c-sec.  I don't see issues with 7 hours of fluids - I see it with
considerably more than that.  And then the wt loss is rapid in the first
24-48 hours but picks back up with proper feeding - not staying low and
getting lower by day 12.  

 

I had to re-educate mom and dad because they were so convinced the 7 hours
of IV fluids made all of this a non-issue.they were quite surprised to learn
the way things should be (pees, poops, feeds, behavior, etc), that their
baby should be back to BW no later than day 14 and that there is no way to
determine how much fluid overload a baby may have when mom is given them and
therefore no way to know what is a safe weight loss for the baby.   They
were also surprised to learn that their gut feeling of baby is having issues
was correct and that, perhaps, Ped wasn't giving out the best advice for
their situation.  The Ped had poo-pooed their concerns.until mom could no
longer take the constant feeding and fussing and gut feeling that something
was really wrong with her baby.and on advice from a friend who knows me,
called me.

 

Mom had said to me right off the bat that she was not interested in
supplementing.  I listened to everything she had to say asked all my
questions and then told her (gently) that there was no way I could NOT
recommend supplementing and I was really surprised that the Ped hadn't done
the same when baby came in 21 ounces below birthweight on day 12.  I
qualified that by stating that probably the Ped was doing his best to
protect BF etc, etc and maybe just didn't realize the scope of the
situation.  But baby was well over 10% wt loss and this was not good.and
this needed to stop now and baby needed to eat.  She was actually
relieved.and agreed immediately to supplementing.

 

After talking with me for quite a while, mom and dad got a hosp grade pump,
are feeding the baby and supplementing with ABM.  I'll be seeing them
Tuesday as they decided to take the next 2 days to FEED the baby, pump
regularly and get things under control.  Now, I know this Dr and I know that
when s/he sees a nice weight gain on Monday (for a weight check) that he
will say stop pumping, supplementing etc.I advised mom and dad against that
advice as we need to figure out what is really going on first.  We don't'
need another weight loss.

 

So, when we get this kind of ridiculousness what do WE do with that?  This
Ped knows of me and has told my clients I don't know what I am talking about
and not to listen to me, has put several babies at risk, and has harmed at
least 3 that I know of with poorly done circs.all of my clients who had this
Ped switched out for a variety of reasons - NONE of those reasons had
anything to do with anything I have said - I have never given a negative
comment.  I have always been very professional. 

 

Help?  Now I need to go find me a new brick wall.Maybe one with padding.

 

Jaye - shaking my head yet again..

 

Jaye Simpson, IBCLC, CIIM

Breastfeeding Network

Sacramento, CA

www.breastfeedingnetwork.net

 


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