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From:
laurie wheeler <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 27 Oct 2005 13:42:51 +0000
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Niki
I wonder about the wt gain. I am going to guess that baby is not being 
weighed naked. It is imperative to get a nude wt in situations like this, in 
my opinion. A 14 oz gain in 2 days is way plenty and the baby could have 
cardiac issues if the wt gain is real. The cardiac issues would go along w/ 
poor milk transfer and hi bili levels. How old is baby now? Bili usually 
peaks around about day 4 and of course the peak will be higher if baby not 
eating/pooping well.
Home phototherapy w/ one light may not decrease the bili levels much. The 
constant crying is very worrisome. If this was my client I would suggest a 
consult for milk transfer evaluation and evaluation of mom's history and 
possible low milk (if that has not already been done), and a consult w/ a 
new pediatrician. From the info I gather from your posts, the current one is 
not giving the mom enough info to explain the situation. Unfortunately (no 
flames please) I have seen many pediatricians who are ignorant about 
jaundice causes/treatment, and use of pediatlye. I have also witnessed 
several pedis prescribe pedialyte for a week or more for a mild diarrhea in 
a basically well baby and d/c the bf as well. Be careful what you say but 
you can let mom know that she may be more comfortable w/ a new doctor and 
remind her that she will want one that she can develop a long term trusting 
relationship with.

Laurie Wheeler, IBCLC, MN, RN
Tupelo Mississippi, s.e. USA

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