Hello Smart Women!
I am in need of brainstorming help.  What follows is a "case study" of a
client that I have been struggling to help.  I'll post in bullet point
style so its easy to read.  What I want to know is if anything jumps out at
you (i.e. what am I missing?).  He has dropped from the 50th percentile to
the 12th and mom is very upset. Pediatrician is not.

DOB 5/10/19 boy at 39 5/7 wks, vaginal birth (NSVD) in a hospital to an MD

BW 7lbs 9oz

Wt at 2d  7lbs 2oz

Wt at 2 mo 11 lbs 3oz

Wt at 3mo 12lbs 3oz

Wt at 3mo + 1 wk 12 lbs 7oz


 Other pertinent facts:


Exclusively breastfed baby.  Mother used shields until 8 weeks.  Feeds
directly now.

Baby feeds 10 x day

Baby feeds 20 mins and generally  both sides

Baby had frenotomy in hospital at 1day of age (only tongue, not lip,
scissors not laser)

Baby had small amount of GERD causing frequent spit up which has resolved


Stools: had frequent up to 2 mo and now has  “massive” stools 1x day and
smaller 1x day

Urine:  very frequently urinates, diapers “always” wet and it appears clear


Baby developed eczema at 2 mo, began on his cheeks, spread to his
face.  Pediatrician
prescribed hydrocortisone “oil” and mother states its helping.


Baby does not sleep with parents, but in a nearby bassinet.  Feeds q 2-3hr
at night with one interval of 5 hours (usually) between 8pm and 1am.


Sibling: Breastfed +- 2 years with great weight gain all along.  Sibling
also started feeding with shield and dropped it on her own at 6 weeks.


Mother's nipples appear undamaged, she denies any pain, feels full if baby
waits more than 2.5 hours without feeding.  Her breasts appear normal to
me, medium sized, mildly flat nipples but evert nicely when baby attaches
(and round on detach)


THOUGHTS!?!?

Libby in El Paso



Lizabeth J. Berkeley, MPH, IBCLC, RLC
Breastfeeding Garden at El Jardin
901 Arizona, 10:30-1 every Friday
915-257-8844

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