I'm STILL trying to help this mom - thanks to all of you for your insights.
I shared them all with her.
Baby is now 6 months old, gained 1 lb since my last visit, so she's now at
12 lbs. 4 oz. Her MD wants her to change to Nutramagen, and mom is willing
to try anything as she has been nursing about every 30 minutes day and
night - or else she screams in agony. Zantac seemed to help a bit, Reglan
made it worse, so she discontinued it.
I saw them today - baby nursed on left breast for 10 minutes, (had recently
been fed on that side) and had 1.6 oz intake (per Medela Baby Weigh Scale),
30 minutes later, she was on the right side and in 15 minutes took in 3 oz.
The MD had asked me to call and give him an evaluation of the
breastfeeding. All I could say was the breastfeeding appeared very
appropriate - (she didn't cry, as she was put on the breast whenever she
cued for a feeding), and she was alert, smiling, responsive, very charming
little girl. So from my observations, I couldn't say there was a supply
problem, or a breastfeeding problem, either. He says there have been
cardiac workups and the original murmer appears to have resolved.
According to his scale she had plateaued and lost 2 oz in the last 2 weeks
(gained the lb in the first 2 weeks then didn't gain any more). I had been
unable to reach the mom as her phone was disconnected (no money) and the
Public Health Nurse had left her a note that she had not answered. She
called me when baby was found to be losing weight again. When I asked her
if she was doing anything differently the second 2 weeks, she admitted to
doing less breast compressions, but actually she felt she was breastfeeding
as often or more as their car blew up and she can't go anywhere, so she
breastfeeds whenever her baby cues.
Any suggestions? I asked her to see a pediatric gastroenterologist
connected with a local hospital Lactation Center, but her funds are so low
(she was denied MediCal because her mother paid for her house payment!),
she hasn't gone.
Jeanette Panchula, RN, IBCLC
Vacaville, CA
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