Hello all,
I could use some help with this situation before it gets out of hand. Mom
is a previous client (1st baby was just 14 months ago). She had supply
problems with nursing that baby and used an SNS but only able to breastfeed
for 1 month. We thought then that it was related to a hormonal imbalance
that had also prevented her from getting pregnant or even maintaining a
pregnancy (had experienced 6 miscarriages).
With this baby (a surprise with no fertility interventions) she seems to
have plenty of milk, but calorie content may not be adequate. Baby is
voiding 6-8 times in 24 hrs (this is at 6 days of age) but has not stooled
for 4 days and weight is 1 ounce below birth weight. Do not have the exact
numbers at home with me but memory says birth weight about 8 1/2 lbs with a
6 ounce weight loss before discharge. These numbers would not concern me
too much if it weren't for her history. The fact that baby has lost another
ounce rather than gain since discharge is causing me reasonable concern.
When I saw her (yesterday) I suggested increasing the feedings to 10/24
hours, taught her breast compression and instructed her to let baby nurse
until done on the first breast (she had been taking her off at 20 minutes)
hoping that the compression would bring more hind milk and even shorten the
feedings a bit. Also suggested more fat in mom's diet, she eats primarily
veggies and fruit. This is a very motivated older mom (40) and has the
patience to let baby nurse for 45 minutes each feeding. I watched a feeding
and all the right signs were there, though baby is rather "laid back",
hence my suggestion for breast compression.
Am I missing something? Can any one give me suggestions? By the way, she
started eating oatmeal while still in the hospital to insure good supply,
but what can be done for more calories in her milk? TIA for any suggestions
Mary A. Banaszewski RN, Lactation Specialist
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