Hi everyone, I passed the ibclc and am so excited.  Anyway I need all of your
help.  I have a mom that delivered a baby at 36 weeks, baby is now 1 month
old.  Since birth the baby has had a good weight gain until 1 week ago.  Baby
is nursing frequently, but the inadequate weight gain was our first clue.
baby regained birth weight in 2 weeks then had a period of 1/2 oz per day for
next week.  Peds at that point wanted to supplement with formula but I talked
her out of it and suggested we wait as that is an appropriate weight gain.  At
the next appointment baby gained 1 1/2 oz in 5 days.  So mom is nursing,
giving expressed milk and supplementing with formula.  Mom describes this as a
completely different baby.  Mom describes 50 cc total breastmilk per pumping
if baby has not fed, No output if baby has eaten.  Baby will take the 50 cc of
breastmilk after breastfeeding and then 40 cc more of formula.  My question is
what amount should the baby be taking and also mom complains of breast pain.
The r breast only produces approx 10cc while the left breast does the rest.
On assessment after the baby nurses the left is obviously drained, the right
still feels engorged but somewhat relieved but you can still feel major
engorgement on the lateral side.  Mom has the pain on the right breast.  Baby
has a good latch and suck and mom reports the pain since birth although she
not mention it until after she started the pumping routine and that seemed to
exacerbate it and it is not better.  Mom is  very frustrated, had PIH without
explanation and was hospitalized the last month of her pregnancy and then
delivered at 36 weeks.  I need all the help I can get.


Thanks a million

Toni Myers Rn, IBCLC!!!!