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From:
Rietveld <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 5 Apr 2000 20:28:02 +0200
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Hi Jan!

I definitely thought your case was very interesting, absolutely worth
posting, not boring and I was eagerly waiting for 'the solution'.
Only thing is that I've thought of about almost everything but the circ!
Circ's aren't normal procedure here in The Netherlands so I've really
learned something ( a lot in fact) from this case. So thank you, thank you,
thank you and thank you for posting this and please feel free to do this
more often.

Hope I've made clear to you that your deed is much appreciated by me :-D !

Renate Rietveld, IBCLC
Rijswijk, The Netherlands


At 11:07 5-4-00 EDT, you wrote:
>On March 30, I posted about what I thought was an interesting case study,
>hoping some people would be interested enough to take some educated guesses
>as to what was going on.  Well, either it was boring, or obvious, or ???
>since only about 4 or 5 responded to me privately, and there was no
>discussion on the list.  Maybe everyone knew the answer already, and thought
>it was dumb...I'm not sure.
>
>Anyway, for those of you who were interested, and for those of you who posted
>to me privately, thanks.
>
>Here's the case study:
><< Baby boy born on Sunday, normal vag delivery, birth weight 8#4 ounces.
>Normal hospital course of events, blood sugars normal, circ, roomed in with
>mom, etc etc.  Baby bf "well" by all reports when he is discharged Tuesday
>evening.  Discharge weight 7-12.  On Friday morning she calls the lactation
>consultant (a friend of mine), and says the baby isn't breastfeeding well, is
>sleeping a lot, and she has to wake him to feed.  States he's pooping quite
>well -- 3 to 4 stools a day which are beginning to turn yellow, but she
>hasn't seen any wet diapers since they went home.  Lactation consultant has
>her come into the office.  Baby is 8#2, well hydrated.  She does an ac/pc
>weight (don't read that part, Heather!!  :>D) and he takes 22 ml.  She has
>mom pump, and mom gets about 75 ml with pumping.  Baby is now asleep.
>  >>
>
>The IBCLC in the case examined him very carefully and discovered there was a
>thin, transparent membrane covering the urethra which had occurred following
>the circumcision.  Baby couldn't pee.  He was immediately sent over to the
>pediatrician who probed it.  Baby voided 120 ml immediately, and then nursed
>voraciously.  Apparently he was in so much pain that he simply shut down, and
>would only bf enough to keep hydrated.  He also lost 4 ounces immediately.
>
>This happened to us once in the Family Birthing Center -- at that time, we
>had a policy that babies had to void at least once before going home after
>they were circ'd.  One particular baby didn't go and didn't go -- parents
>were dressed, ready to get out of there, and punkin' still hadn't peed.  We
>did every trick known -- warm water over the penis & scrotum; tickled his
>back, put him naked on a nice bedspread, pressed on his bladder.  Finally, at
>about 12 hours we looked VERY carefully -- and sure enough, there was this
>very thin membrane covering the urethra.  Called the peds who got a urologist
>over there who probed it, and all went home.
>
>Jan B in sunny Wheaton.
>
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>

--------------------------------------------------------------
Renate Rietveld, IBCLC
E-mail  : [log in to unmask]
Homepage: http://www.casema.net/~rietveld/index.htm
--------------------------------------------------------------

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