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Subject:
From:
Becky Krumwiede <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 5 Apr 2000 22:53:03 EDT
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Thanks to those who wrote with suggestions.  I did feel better after
rereading Dr. Jack's JHL article this morning about the baby with 30% weight
loss.

Baby gained 4 oz since yesterday with supplementation and looked much better
today.  When I have a better idea what the problem is/was, I'll update again
(I hate getting hits in the archives that don't have the outcome).  The birth
weight was likely accurate.  Birth weight was 8-13.5, discharge wt. on day 2
was 8-4, baby was seen in the office for jaundice on day 4 with bili of 17.5
and wt. of 8-1.  Unfortunately, nobody weighed him again with subsequent
bili's in the hospital lab.  Bili on day 5 was about 18.5, on day 6 about
19.5 when bili blanket was started and continued until day 9 when bili was
13.5.  I'm guessing when the bili was climbing the weight was dropping but
nobody knew.

Mom nursed her 16 yr. old and 10 yr. old for a year with no problems.  She
said this baby initially had trouble latching but did better once her milk
came in on day 3.  It is so hard to believe she didn't notice how scrawny
this baby had become, but I know it happens.  We even give out a
breastfeeding diary to keep track of feedings and output for the first week
of life; I think she used it only the first few days and was reassured by the
initial output.  Her life is stressful with oldest child autistic and husband
lately working out of state.  I can't begin to assess this child's
breastfeeding at this point because he is so weak.  At the consult yesterday
I thought he latched pretty well under the circumstances, although the latch
was shallow and he fell off the breast easily.  I can't imagine any baby with
this much weight loss could breastfeed decently.  Yesterday I only checked
for the obvious--no tongue tie, palate intact all the way back.  Mom reported
feeding every 2-3 hours all along with an occasional longer stretch.  I'm not
comfortable with feeding devices when a baby has lost a large amount of
weight; I just want to make sure baby eats plenty and regains some strength.
Mom is nursing at breast for the short time he's awake and suckling well,
supplementing with a bottle, taking fenugreek, and double-pumping with a
hospital-grade pump.

Becky Krumwiede, RN, IBCLC
Appleton, Wisconsin

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