Heather, Joann and Margaret,

Thank you for your responses. I know it was a confusing and somewhat
overwhelming post with interventions everywhere.  There are a couple things
I want to address from Heather's post.

(A baby who is sleepy and not gaining well? The mother does not need to be
messing about with two different herbs and an in-home scale and weighing.
First thing to do with a sleepy slow gainer is to get mother and baby
together, feeding, with someone observing at least one feed all the way
through. The usual cause of slow gaining is not enough milk getting into the
baby - that's usually easily fixed with more feeding, day and night, using
both breasts at least. Maybe breast compression if the baby is too sleepy.) 

 Heather, I totally agree with you here!  Mom did this on her own or from
the advice of someone else.  You just must of missed that in my confusing
email.

>Mom calls me when baby is 5 wks old and very fussy. Gaining well. But 

>eating 5-6 oz every 3-4 hours! (now 9#) Mom pumps off 15 oz(!) after 

>am feeding.

(!!!! That's crazy, sorry - what is the mother thinking??....pumping this
amount is going to send her supply sky rocketing. And why is she feeding
with a bottle (am assuming she is doing this, otherwise she would not know
how much the baby is taking. So that's more expressing, more
over-stimulation, more fuss, more messing about.....)  

She was pumping off this much because she was engorged in the mornings.  She
was undoubtably overdoing it by pumping till she could get no more, versus
pumping just to soften.  The reason she knows how much the baby is eating is
because she still has the baby scale.  So, she isnt bottle feeding.  She is
doing pre and post weight checks with each feeding.  (which I don't
recommend, and didnt recommend)

>* obviously oversupply! AND reflux, as baby refluxed several times in 

>my clinic whenever placed semi reclining. Note to doctor, baby started 

>on zantac.

So this baby is now *medicated* because of the mother's super-stim of her
supply :(

Yes, unfortunately, it didnt seem as easy as just working on "one" thing.
In my office, she did RCT to release the fast flowing milk, and we had a
very slow, calm 3oz feeding.  She was happy for about 10 minutes before
starting the gagging and crying.  She would settle only in a totally upright
position in moms arms.  Mom reports the baby sleeps in her arms most of the
time, as wakes up when prone.  The baby actually had one of her worst
episodes in my office, and it took several seconds for her to catch her
breath with the reflux.  So, it does appear this baby needs some form of an
antacid.

Today, she reports the baby eating 3 1/2 oz, consistantly, and pumping off
another 1 1/2 oz.  I told her the supply seems very normal and to stop
pumping after feedings.  (remember she has a scale and is doing pre and post
feedings)  If she wants her baby to be able to take a bottle, then to
continue offering at least one every other day of her pumped milk, and to
pump for those after the morning feeding.  (and to pump after the first 2
morning feedings if she needs to in order to collect 3-4 oz)  I also told
her to NOT wake the baby up at night to feed her anymore, as her wets/soiled
diaper count is normal, so she doesnt seem to need to worry about
dehydration or diarrhea anymore.  After she does this for a few days, I will
encourage her to wean herself from the scale!  She had her thyroid checked,
but the results are  not in yet.

In the archives, there was another very similar case, and it was due to the
moms thyroid.  

Linda Hill RN, IBCLC

Austin, Tx


             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome