You may remember me posting about a 46 year old mom who had a baby girl by
"embryo adoption".  I just saw the baby for a 2 month check up.  Baby was
born at 6 lbs 8 oz.  At hospital discharge 4 days after birth, baby was 5
lbs 13 oz.  At 1 week (7 days) baby was 6 lbs 2 oz.  At week 2 (14 days)
baby had lost weight and weighed only 5 lbs 15 oz.  At that point, she was
encouraged to start breast compression, some post feed pumping and
supplementing with pumped milk, and close monitoring.  We had frequent
contact and baby always had adequate wet and poopy diapers and was alert and
active.  At 3 weeks baby weighed 6 lbs 2 oz, at 4 weeks 6 lbs 8 oz (birth
weight) and at 5 weeks 6 lbs 15 oz.  Mom and I were fairly happy with this
weight gain then, and decided to weigh baby in 2 weeks.  However, due to
scheduling issues, we did not weigh the baby again until yesterday, which
was at 9 weeks of age.  Baby is now 8 lbs 4 oz (3rd percentile for weight.)
 Overall, since her low point of 5 lbs 15 oz she has gained 37 oz in 7
weeks, or about 5 oz a week.  Baby looks alert and active, has about 2-3
yellow, seedy stools a day and about 6 wet diapers.  Baby is smiling,
reaching out to interesting objects, holding head and back well, and even
has rolled over front to back so she looks very developmentally appropriate,
just very tiny.  Mom feels, though, that she has to nurse the baby a lot to
keep up with her - at least every 1 1/2 to 2 hours and has occasionally
supplemented in the last 2-3 weeks with ABM, generally on the order of 6-8
oz in a week.  Mom never feels very full, except sometimes in the morning,
is able to pump only about 1 oz total (although this is in addition to
feeding the baby directly)  She is returning to work full time as a high
school teacher in 1 week.
I can't decide if this mom and baby are doing fine, or if mom's milk supply
is just barely adequate now and is at risk for having more trouble keeping
up as time goes on.  Any opinions?
Jennifer Tieman
Family Physician
Mom to 4, including nursling Caroline Rose born 5/31/03

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