Cindy,

In Ruth Lawrence's book (among other resources) she says a 7% weight
loss is expected in a breastfed baby at first.  By 10% it is necessary
to intervene because something is not right!  By the time a baby is
readmitted, the mother should be pumping regularly (because milk has
definitely not been efficiently removed on a regular basis) and the
baby need to be fed regularly, hopefully using an alternate feeding
method.  The breastfeeding needs to be evaluated and followed by an
LC.
When I did private practice I found that it was not uncommon for babies
to get "hooked" on finger feeding as well.  Any time you feed a baby
away from the breast you of course run the risk of having the baby
prefer that method over the breast.  But reasons I am such a fan of cup
feeding is that it is so simple (as compared to finger feeding from a
parent's perspective) and is easy to teach (usually), and requires
simple "equipment" that parents don't find as intimidating.  Anecdotally
I don't see as much "getting hooked" on cup feeding as with finger
feeding.
About the weight parameters...I sometimes think we should be watching
weight closely and actively intervening (to correct breastfeeding
techniques) when weight drops below 7%.  Don't you feel that by 10% we
are playing catch-up?  By 18% we had better be feeding aggresively!
Edie Armstrong, BSN, IBCLC, Fairfax, Va.
>
> I have been working for the past 10 days with a mom who has almost flat
> nipples and large breasts and who delivered a baby girl 4 weeks early.
> In the hosp baby nursed well, then at the day of d/c mom gave baby a
> pacy, and when baby got home she only nursed for 3 - 5 minutes every 5
> -6 hours. Mom went home on a Thurs and I made a follow up call to her on
> a Sun, mom reported this poor nursing pattern and only 1 small BM since
> the baby had been home. Mom came in for me to see her and nany, baby had
> an 18% weight loss from birth and was not latching on well at all. MD
> was notified and electrolyes were ordered and baby was mod dehydrated
> and readmitted for IV's and to work on the nursing. Baby was very sleepy
> for about 24 hours and whouldnt latch at all, despite repeated efforts
> by this very patient mom, after that time baby was more alert and all
> she wanted to do was cry at the breast, we took pacy away (upon moms
> approval) when baby was admitted. Baby was finger fed expressed
> breastmilk for the time she was in the hosp and got hooked on that... so
> as a last resort , we had already been using the SNS without any luck, I
> uses the SNS and the silicone nipple shield together, and got the baby
> to nurse, :) but baby would only do this sporadically, baby really
> wanted the ff. Baby was dc and 24 hours later had lost 2 ounces and 24
> hours after that had gaoined a few ounces.... mom mostly pumping and
> feeding expressed milk and suppl with formula...
>
> Does anyone have any ideas or tips on how to get his little one to
> breast again??
>
> Also , I was wondering do any of you figure the % of weight loss in
> abbies on a regular basis? and if so at what point )what % of loss
> do you and / or the docs get concerned? Our docs start to get concerned
> at the 10% point.
>
> TIA
>
> Cindy~~~
> --
>
>                 <*><*><*><*><*><*><*><*><*><*><*><*><*><*><*><*><*>
>                 {       Cindy Curtis , RN , IBCLC                 }
>                 {        Virginia , USA                           }
>                 {         mailto:[log in to unmask]              }
>                 {          http://www.tidalwave.net/~cindy        }
>                 <*><*><*><*><*><*><*><*><*><*><*><*><*><*><*><*><*>