In a message dated 3/12/98 12:51:32 AM, Lynelle wrote:
<<......The other group feels that a 10% weight loss is a critical situation
that requires immediate action, usually in the form of formula
supplementation.
I would like to hear what protocol people on this list adhere to >>
The nurses assessment of the mother and baby is comprised of comprehensive
parameters, including weight status. We use all these observations to help us
plan care.
Last week a nurse reported to me that a baby who had gone home earlier that
day had a weight loss of 11% (c/s and the works). The nurse had reported the
wt loss to the ped also, before the baby went home. The ped said that "if
lactation thinks that supplementation is called for then its fine" with her. I
was glad she did not automatically order supplementation. In the hours before
release from the hospital the nurse had continued to work with position,
latch, and more frequency and duration at breast as the situation was then
allowing. The nurse related how this had shown to be successful as mom was
filling nicely, position and latch continued to improve, heard swallows.
I called the parents at home to discuss how things were going and asked them
to bring the baby back to the hospital the next day for a weight check so that
we could use the same scale that the baby had been weighed on in the previous
days. This is something we do as indicated. (A less optomistic assessment by
the nurse would have lead me to give different advice.) Parents came in for
the wt check about 23 hours after discharge, reported that baby had breastfed
11 times ("and stayed on alot") since going home from the hospital.
When I talk to new parents, at some point, to make a point, I am likely to
look at the dad, or whoever is there, and say "now, she should be eating,
sleeping, and feeding the baby, and that's about all for the next few weeks".
I too often get a look like "are you insane?" and then I explain why I give
that ideal to strive for and how Dads role as protector can be used to support
his family in these ways. This dad was the type that obviously didn't need
that advice. Mom looked fresh and well rested as Dad had cared for baby while
she slept except for feedings.
When we checked the baby's weight we all said "WOW!".
Deb
Deborah Tobin RN BSN IBCLC ACCE
Springfield,VA
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