I'm with Genia.  A baby can look pretty good clinically on one day, but if
baby's ability to compensate is nearing its limit, the appearance will
change fast.  A baby can also improve really quickly with a little food, as
noted in Jennifer's post!

I also agree with Jennifer that the weight loss was serious at the time the
RN saw the baby.  Unless the RN left written instructions which Jennifer
saw, all Jennifer has to go on is what the mother recounted about the advice
she was given.  So as Genia suggested, I would strongly encourage getting in
touch with the RN (if the mother consents) to compare notes.  Second-hand
information is hardly ever as good as first hand.

It was the doula who brought in more breastfeeding support, and it would be
informative to know why she felt the need to do that if the baby was being
followed by someone else in addition.  But it all seems to come down to a
lack of awareness on the mother's part about what should trigger concern
about feeding behavior, intake and output in a new baby.  Was the doula
involved all along, or did she come in after the first few days?

You could start the conversation with the RN by saying 'NN's doula called me
to see the baby the day after your visit, and when I met the mother, she
couldn't remember whether you'd said anything about how much milk the baby
should be taking in 24 hours, or how often the baby would be expected to
feed, she only remembered the tea you suggested (and then mention whether
the mother was using the tea or not!).  She also didn't seem to have picked
up that a baby who is that far below birth weight at one week should be
wakened to feed if it hasn't woken on its own after a long stretch like 3
hours.'  And then mention something light-hearted about postpartum fog, and
that's why we write things down to leave with the mother...  Give her the
benefit of the doubt and it will be easier for her to take in what you're
saying.

Rachel Myr
Kristiansand, Norway

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