A baby who is 12% below birth weight, as this baby is, at 18 days of age is not doing well.  It is astounding that a healthcare provider (the midwife/CLC and pediatrician) would say this.  I have to wonder when they last saw the baby.  An 18-day old baby could easily take 3 or 4 ounces (or more) in a feeding if feeding and weight gain have been proceeding normally.  Just as important as the amount taken in one feeding is the number of times the baby eats in a 24-hour period.   Is the baby "sleeping through the night"?  That is another warning sign.



I agree this is too complex to handle via phone or email.  This mom needs to feed the baby. Can you check the ILCA website to find an IBCLC in her area?  (Go to http://www.ilca.org and click on the "Find a Lactation Consultant" link at the bottom of the page.)  I would strongly urge the mother to return to her pediatrician.  I would also let her know that supplementing with water is not advised for babies this age as it provides no nutrition. It sounds like she would do well to see a different pediatrician if the last one advised water and prune juice to help this baby.  



If the baby weighs around 9 pounds (which he may not anymore), he needs to eat about 22 ounces or more per day in order to begin to gain well.



It sounds like the mom has other children (you mention she's gone 10 yrs w/o a baby).  Is the mom not taking time to focus on the baby's needs?  Does she have help?  Is the older child/children able to help with household tasks while she focuses on getting the baby back to birth weight and back on track?



I echo what others have said that this is an urgent situation and the baby needs to be fed.  It's hard to imagine that this baby could be described as vigorous.  I'm picturing a skinny baby with a very worried look, becoming lethargic.



Sara Dodder Furr, MA, LLLL, IBCLC

Quality Improvement Specialist

Office of Research, Policy & Quality Improvement

Health Licensure & Investigations Unit, DHHS Division of Public Health 

P.O. Box 95206

Lincoln NE 68509-5026

Phone:  (402) 471-4973 FAX:  (402) 471-0383

[log in to unmask] 

Website: http://www.dhhs.ne.gov/crl/crlindex.htm 







-----Original Message-----



Date:    Sun, 17 Jul 2011 18:36:56 -0700

From:    Liane Varnes <[log in to unmask]>

Subject: Newborn not having bowel movements



Permission to post: Baby dob 6/30/11 at home to a mom after 10 years w/o a baby... Today is day 18 and no more bm's. Mom has not tried another enema. As of Friday, baby weighed 8#6

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