To add to the hair-pulling events:
Twins, 34 weeks, 4 lbs and 3lbs. 14 oz - discharged without even a scheduled peds appointment for 5 days.
Luckily WIC referred the mom, and provided a breast pump
Luckily the PHN who got the referral called her on Friday morning, and through a translator found that this mom had suffered depression with her previous (18 month old) child, as well as the gestational ages and weights of the babies.
Luckily the PHN called me (who could translate AND provide breastfeeding help) and we went off to visit her at 5:30 pm.
Mom had been told to wake up the babies - but not HOW
Mom had exclusively breastfed previous child - but only on one breast - he had refused it, and so were these twins.
Mom had not learned how to latch and position these tiny babies, and had no formula, either.
So we taught her how to unwrap and awaken the babies and latch them on to both breasts, what kangaroo care was and how to offer it to her babies, (taught Dad also), provided her with a pump to initiate lactation on the left breast, etc....
THEN we also provided her with my pager, the 24 hour emergency hotline, etc. and encouraged her to feel free to use either throughout the weekend.
On my follow-up phone call on Monday after her doctor's appointment - mom had done wonderfully, both babies were being awakened q 2 - 3 hours, had gained weight and mom was very calm, confident and with extra milk in the refrigerator in case they fell asleep and still had not eaten enough -
BUT the doctor, seeing how well things had gone - told her to LET THE BABIES SLEEP AND NOT AWAKEN THEM AT NIGHT! (yes, I'm shouting!!)
Luckily (or if you are a believer ... then Thank God) mom had a clear understanding of WHY her kids were doing so well - and stated she was going to continue to awaken them, feed them, kangaroo care them when possible...
AARRGHH!
Jeanette Panchula, BSW, RN, PHN, IBCLC - with some of my hair still intact!
California
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