Hi all,
I saw a mom a week ago with a 2 wk old baby who had down 6 1/2 oz from birth
wt.  Mom was not feeding frequently enough and baby had a nibble latch on
taking in only the nipple not the areola.  Baby was having few wet diapers and
had stooled only 2-3 times in the 2 weeks.  We corrected l/o and positioning
and baby was quite willing even while in the office to take in the whole
areola.  Increased bfings to q 2 hrs during the day with one or 2 3 hour
periods at night.  Mom definately complied with instructions and kept a log
which I saw when they came in today.  Baby's bms have increased to several each
day often one with each feeding, though they still are somewhat dark in color
and not quite the mustard I would like to see.  Plenty of wet diapers, but baby
only gained 1 1/2 oz in this one week period.  Baby was wedging mom's nipples
when I first saw her and while she appears to be on the breast correctly I am
still seeing some wedging of the nipples.  I think this is happening near the
end of the feed when the baby starts to pull back.  I have sent mom home with 2
hour feeds around the clock and using an electric breast pump with double kit
for 10 min. after each feed during the day to see if we can get the baby's
weight moving up.  I do see nice deep sucks and hear swallowing when baby is at
breast and mom confirms she is seeing that at home, as well.  I am seeing them
again on Fri. - 3 days from now.  Any suggestions?