On Wed, 17 Jul 1996 [log in to unmask] wrote:

> Have a first time mom from Pourito Rico, she is also an RN,Baby is
> 16 days old, birth weight was 7 lb 14 ounces, weight today 6 lb
> and 7 ounces.  Mom reports baby breastfeeding CONSTANTLY, almost
> all day long, baby sleeps better at night , sleeps for 2 - 3 hours
> at a time, wakes and feeds well according to mom.  Mom reports
> baby having infrequent stools.  Was 1 every other day, now stools
> are several days apart, baby has gone as long as 5 days without a
> BM, stools that baby are having are brownish yellow, oatmeal
> consistency. Last BM yellowish orange "creamy" consistency.Ped is
> supportive of BF but has refered her to surgeon because of
> decreased BM's.Im not sure if this is necessary???  Mom states
> that if she has 2 hours between feedings her breast do feel full.
> At night her breast feel full , but in the day time she goes not
> more than 30 minutes between feedings mom does feel tingling
> feeling sometimes with nursing.  This mom really really wants to
> breastfeed.....Ped has NOT recommended formula :) Any ideas or
> suggestions that you have will be most apppreciated.... Thanks in
> advance! I will be seeing mom in my office tomorrow morning
> (thurs) so please respond asap... Thanks again.

Cindy, some thoughts:

- No, I don't think a referral to a surgeon is appropriate for decreased
bm's unless the baby's belly is distended or there are signs of
obstruction and what you describe doesn't seem to fit that diagnoses.

_ Is the baby having wet diapers?

- Is the mom hearing swallowing?

I would really want to see the baby nurse, evaluate the suck, maybe do a
weight check before and after if you have access to a Baby Weigh Scale.

- Has the baby had a good physical exam? Lab workup? What about mom?

I would suggest an SNS in this situation I think.  I suspect that this is
a baby that is either not nursing effectively or there is something
interfering with mom's milk production.... In either case, an SNS would
keep the baby at the breast, and provide extra calories.

Let us know what happens when you see the mom.

Ione, CNM, IBCLC