Hi everyone,

 

Well, I suppose I should have waited till I was less tired to write my post
and descriptions. :-) Rachel you asked some good questions.  :-)  

 

The baby in question was 7 days old at time of LC visit.  She was 8’15 at
birth and 8 pounds on day 7.  This is just over a 10% weight loss.  Baby was
also getting more and more lethargic and spacing out feedings quite a bit.
Parents were not aware of how to watch for lighter sleep states to wake for
feeds and were missing those important cues – which I didn’t which is why
she got to eat again in 2 hours (after the start of the first feed) rather
than 4 (which turned out to be the usual situation).  She was also jaundiced
with a bili of 17 and Dr was recommending supplementation.

 

Parents did 24 hours of pre/post weights where baby continued to exhibit an
inability to consistently get what I would consider a decent feeding at
breast given her circumstances.  At breast in 24 hours she took in about 10
ounces (this is with breast compressions, stimulation, etc) with some feeds
being 1 ounce or more (one was again 1.8) and others being less than .5 (1/2
an ounce) – parents supplemented with another 5 ounces of expressed
breastmilk (baby would not take more than the 5 extra) for a total of 15
ounces in the first 24 hours.  

 

The 2nd 24 hours she started waking more, being more alert and her feeds got
better taking in about 17 ounces at breast with amounts being much more
consistent – over 1 ounce at all feeds and some close to 2.  Parents
supplemented with 3 for a total of 20 ounces in 24 hours.  

 

The 3rd 24 hours she had no supplements and took in 23 ounces at breast –
varying feed amounts but amounts were such that they were acceptable (more
than 1 ounce) and baby was satiated.  She was alert, waking for feeds,
nursing well, jaundice well under control.  Mom was also pumping to
stabilize her supply and supplement with EBM during this time.

 

So – in this case, in my opinion, the scale and the amounts were quite
important because the parents would have been content to let their baby
sleep thinking she was a good baby.  Also, they knew that the first day (24
hour time period) with 15 ounces into the baby, it still wasn’t’ quite where
baby needed to be for her birth weight intake (approx. 22 ounces) and knew
to keep working.  This baby wasn’t transferring well due to lethargy – in my
opinion, and only my opinion, this baby was well on her way to a crash and
burn…hospital visit was likely the next step.  She was unable to get the
milk she needed, and needed to improve quickly.

 

I have the luxury of owning my own scale (Tanita BLB12) and I count on it
quite lot.  While I am capable of observing a good feeding, it is the fakers
that get us all.  That is precisely why I use my scale and sometimes stay
through 2 or more feeds so I can get a better picture of what is going on
with the baby.    Also, I know there are times when healthy babies will take
‘snacks’ of ½ an ounce here and there.  I don’t worry about that – I only
worry when the baby is NOT healthy and growing or gaining well.  Those
babies are at risk for lack of adequate intake. 

 

Hope this explains things better.  :-)

 

Warmly,

Jaye

 

 

 

 

 

 

 


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