Reading archives and finding anemia and low milk supply connection, but seem
to be more related to postpartum anemia.  Wondering if the same applies to
long term anemia?  Mother reports being anemic as long as she can remember and
always on iron supplements.  Says she can't remember every having a hgb level
above 9, and as low as 7 during this pregnancy.  Has always taken iron
supplements, and prescription during pregnancy.  Her baby's weight gain is slow.
Catching up after a rough beginning that impacted supply from delivery until day 8,
and then even a couple days beyond that as corrections were being learned.
One ped very calm and taking wait and see approach with a slow weight gain, but
no longer a loss.  Other ped insisting on formula of ounce and a half each
feeding.  Baby not interested, and mother had to feed to baby while sleeping
(fell asleep after nursing usual 20 min.).  At this point, baby has gained only 4
and a half ounces in a week (which is more than week before, and after a week
of lost weight)  So, now baby is at 25 days back to birth weight, stooling
several times a day (Thanks for the handout of baby poop.) much larger than a
quarter each time, and at least once or twice a full diaper, and also more than
6 wet diapers. (Parents say changing a diaper at every feeding and sometimes
again afterwards.)  This is a huge change from no stools for 48 hrs and then
only green small, less than quarter.    I see it as improvement, parents see it
as improvement (are assuming their other ped would too) and I don't want to
push to shove the formula down.  BUT, and this is the question...IF the iron
deficiency of the mother could be interfering with her milk supply, perhaps her
baby is just content with the milk receiving?  (That just doesn't match up with
the diaper count, though.) And, if the iron is an issue, and her supply is
really low (and I am just missing it because of initial visit mother was just
that day seeing her breasts full) what can she do to correct it (other than the
usual which she is already doing) and in terms of iron issues, is it something
that can be reversed for her supply to increase (if it is indeed low in the
first place.)    Will see the pair in a couple days for another weight check
before a return to the pedi's office.  Right now, they are trying to decide to
use formula or not to use formula.  They really do not want to.  But, if her
iron status means she will always have a low supply, she would not want her baby
to need more and her not feed the baby.The zebras are there sometimes, ya
know?
Thanks,
Pam MazzellaDiBosco, IBCLC
FL, USA

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