I have seen this weight loss scenario many times, where it would not be
possible for the baby to lose that much weight in such a short time.  I
often joke to the staff to stop putting the baby on the treadmill.  At a
conference this year, Kittie Franz said that "shortening the cord" could
account for a 6oz. loss.  This was a new idea for me, and my co-workers.
Now we just need some documentation, like a before and after weight if the
cord is cut.  If you have not seen many fresh babies, sometimes the cords
will be 6 inches or more.
Lu Bush
RNC,IBCLC
Texas
----- Original Message -----
From: "Ann Perry" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Thursday, August 22, 2002 8:44 AM
Subject: teaching an old dog new tricks


> I need to get on my soap box for a minute and I know this crowd will hear
me
> out.
> This week I was working with a second time Mom and the breastfeeding was
> going well.  I was informed by the nursery staff that the baby had dropped
13
> oz (the baby is only 36 hours old).  I told them it must be a scale error.
> They insisted it was not and that the baby was not getting enough.  They
> called the pedi and word was out that the Mom would have to supplement.  I
> checked the orders and all that was written was for a LC visit and I could
do
> that!  I observed and charted; the baby swallowing, fontanels were normal,
> skin turgor good and mucous membranes moist.  Also the baby had voided 6
> times and stooled 4 times since birth.  Mom was concerned with what the
staff
> had said so we agreed she would nurse more.
> The next day a different staff said it was a scale error but the pedi was
in
> the nursery and wielded on me for not agreeing with her recommendation to
> supplement.  I tried first to get a rational of why a baby at 36 hours
could
> lose so much weight knowing what is the normal intake.  Her responce was
she
> did not care what the literature said.  Then I tried to reason with the
other
> physical findings on this baby and she just kept focussing on the reported
13
> oz weight lose and that she had to act on that, which was for the mother
to
> supplement.  Then I said the mother had increased nursing why would that
not
> be acceptable and she said that was not the orders she wanted.
> When I went to see the mother and informed her that the weight was OK she
> told me the staff had come in during the evening asking her why she was
not
> supplementing.  She said I don't want my baby to get formula.
> I love my job because I know who I advocate for, BUT trying to reason with
so
> called intellegent professionals drives my blood pressure up.  I want to
make
> it very clear to this group that I do not feel all maternity nurses are
like
> this or pediatricians but the few bad apples sure do stink up the whole
group
> sometimes!
> Thanks for letting me vent and if any of you wise ones know of a way to
teach
> this small group correct information, I would love the help.
> Ann Perry, RB IBCLC
> Boston, MA
>
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