Kathleen,
Your post touched a cord in me so for once I would like to reply. Based on
the fact that this baby was very sleepy,very jaundice and 1lB below birth
weight I would not hesitate to start supplementing the baby with formula
ASAP,following the criteria of 120 Cal per kg per day. I find that these
moms have an OVERWHELMING fear that they are starving their babies and
until their babies start gaining they are VERY stressed out. From your post
my hunch is that this mom has a compromised milk supply and that this baby
started to get into trouble very early on.

In my experience I have found that if a mom is not 110% motivated there
will be a very low compliance rate for using the SNS. It's just too much
for many moms. I feel the SNS is a great tool but I really have a hard time
getting moms to use them in the home setting. So, cup or finger feeding
seems to be the tool of choice for many of the families I work with. If
they have to use these tools for more then 3-5 days again the moms start to
really stress,then I go to a Haberman or Avent bottle.

As we all know, feeding the baby and protecting the milk supply is the
goal. Once the baby is stronger and gaining well hopefully the baby will
nurse better. A bili level and a doctor to evaluate baby to rule out any
medical problems is a very good idea. I like to call the Ped with a phone
report for babies like this. The Peds like it and it will cover me legally.

I would increase moms milk supply with herbal galactogoges along with
pumping at least 8 times a day with a good electric breast pump.

Thank you for helping this couplet.

Warmly,
Star Siegfried RN,BA,IBCLC
Arcata, Ca.
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