Baby is 3 weeks old.  He has at least 4 large stools a day and his diapers
are heavily wet with clear urine. I don't know how many wets because mom
forgets to count. I have her on a "must count" routine for 24 hours. Most
of the stools are the usual yellow seedy kind. When I have changed his
diaper, it is very heavy with urine.

Twice, in the evening he has had "bright green stools."  These stools were
accompanied by crying and wanting to be at breast off and on for hours into
the night. My thought was oversupply with fore/hind imbalance. I suggested
breast compression and trying to get him to feed long enough to get the
hind milk.

By the way, he is feeding only one side, never could latch onto the other
side, which is more fibrous.  Mom is satisfied with one side feeding--in
theory, at least. How does one decrease the milk supply if mom is feeding
only one breast?

The morning after his first hard night he fed well, slept well, and had
yellow, seedy stools, and heavy wet diapers. All seemed well. Happy baby.

Then a couple of days later he had another evening of green stools and
crying.  We looked at mom's diet (she doesn't use dairy) and found that she
had been drinking a lot of apple juice all day. So she has eliminated the
a. juice for now. The day that he was ok, she didn't drink any apple juice.

This last evening they called the doctor's office at 10 PM.  Doctor called
back the next morning and said that it sounded like he is hungry, give him
abm.  Mom pointed out that she is allergic to dairy and doesn't want to
give him that, so soy was recommended. After talking with me, she hasn't
given it to him yet.

When I am there he feeds very well, staying on for 25+ minutes with several
bursts of suckling, eyes open, good style and rhythm. I have been there in
the AM and in the PM and can't tell any difference in his satisfaction at
the breast with time of day.

Now, I am wondering if some of this is perceived low supply.  Her first
night after the birth a nurse told her that she must feed on both breasts
or he would never get enough.  He would sleep and she would think that he
was satisfied, but he would be starving and would be too weak to feed.
Now, if he sleeps she thinks that he is hungry but too weak to feed, and if
he cries she thinks that he is hungry and is not satisfied.

He regained his birth weight by his two-week check-up. She's wanting to
take him in again tomorrow for a weight check, his 4th since he came home.
She is so anxious about his well-being.

She is also concerned that when he straightens out his legs his knees are
wrinkled.  She asked me if that means that he is not filling out his skin.
I must say that I don't know if a baby's knees' wrinkling means that he is
too thin.  When I pinch his thighs he has subcutaneous fat, and he "looks"
healthy--bright-eyed and good color, however I know that many of you
question "looks" as a gauge of satisfactory growth.

Should she just rent the Baby Weigh for a few days? Should I move in for a
few days? Should I turn her over to the Ped and let it go? Should I go take
a hot Epsom Salts bath with lavendar and pretend that I am not a lactation
consultant?

Patricia Gima, IBCLC
Milwaukee, Wisconsin, USA
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