>Just saw a 9 week full term baby who has not gained any weight in 
>the last 4 weeks.  This is mom's 4th baby and she nursed the rest 
>and states they did fine but gained weight on the slower side.  Pre 
>and post feed weighs show intake around 30+ ounces in 24 hours. 
>This may be more than the baby was taking before, because now with 
>using both breasts per feed, massage and compression and more 
>frequent feeds the baby has now gained several ounces.  Mom with 
>hemoglobin of 6 after delivery, received blood, and was very anemic 
>during pregnancy.  She saw peds the day after our visit and he 
>states that he feels the anemia is affecting the quality of her milk 
>and wants her to get another hemoglobin level drawn.  Not sure what 
>his thoughts are going to be after the labs come back.  Any thought 
>on infant weight gain and anemic mom???  She doen't seem to have a 
>supply issue related to being anemic.  She is concerned because she 
>does not see a lot of fat in her milk.  We are working on increasing 
>quantity of intake.


The vast majority of problems with weight gain in otherwise healthy 
babies are down to intake - the baby just isn't getting sufficient 
milk.

This baby is in crisis - no weight gain for four weeks is really 
serious, and the baby will look undernourished....one wonders who was 
providing health care to let the baby 'drift' like this, though maybe 
no one saw the baby, and she went for four weeks without any checks 
or weights (which is of course fine when there are no problems!).

Getting another blood test won't put weight on this baby or help 
him/her to grow. I hate this - testing and testing as if the testing 
itself addresses the issue!!

The anaemia will not affect the fat in her milk (unless there has 
been some research I don't know of?). It might make it more difficult 
for her to produce sufficient quantity.

Your own suggestions to feed more (I would say switch nursing would 
be better than 'both breasts per feed'),  and compression are good 
(why massage, though?) and have obviously helped. I'd be worried 
about this baby, even so.....the concern is that he/she is not 
energetic enough to transfer milk often enough and effectively 
enough. Can she supplement with expressed as well? It would be a 
question of judgement whether this baby would benefit from 
supplements on top of this, via donor milk, or even formula.

Heather Welford Neil
NCT bfc, tutor, UK
-- 

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