Jessica Billowitz wrote:
>I unfortunately saw one of those cases Thursday that make us all cringe.
>First birth, baby 300 g under birth weight at 4 weeks.  Baby looked
>surprisingly well for this situation.
>What had me stumped was that the mother said the baby makes at least
>7 diapers a day of stool and the diapers are also quite wet.  I of
>course asked to see the days diapers and the stools were light
>brown/yellow and on each diaper there was a nice amount.  They were
>also pretty wet.  How is this happening with so little milk
>transfer?  We did a test weigh after I corrected the latch and the
>mother felt a huge difference in the feed and the baby only
>transfered 23 cc.  How could the baby have such output?

Hi Jessica,
I have seen similar scenarios to this.

My theory always is that if plenty is coming out the 'bottom end',
then lots must be going in the top! If the baby is exclusively
breastfed (was this checked??), then there may be an absorption
problem. This can be as simple as lactose overload, from too much
milk, too fast (ie oversupply, overactive let-down), or there may be
a food intolerance, or some other more medical reason for poor
absorption. Any signs of allergy in the family?

Is baby happy, or crying a lot? Alert and demanding feeds etc, or
very sleepy? Acting 'colicky'? Asking for frequent feeds? Wanting to
suck *all the time*?

In what context was the test-weigh? Just one of *many* feeds a day? I
am not a great fan of test-weighing (meaning I don't do it - please
only throw soft objects everyone ;-). I think it can be misleading.
When you say she 'felt a huge difference in the feed', do you mean in
comfort level now the latch had improved, or a huge difference in the
hardness/softness of her breast, meaning she thought the baby took a
lot?

Was the birth weight *real*? Did mother have lots of IV fluid that
may have inflated the baby's birth weight? Could there have been any
error on recording weights?

Just a few questions off the top of my head to try to get a fuller
picture of this dyad. You mention the condition of the baby looked
good - this is significant too, rather than relying totally on
figures to assess progress.

Please let us know how this turns out.

Joy
******************************************************************
Joy Anderson B.Sc. Dip.Ed. Grad.Dip.Med.Tech. IBCLC
Australian Breastfeeding Association counsellor
Perth, Western Australia.   mailto:[log in to unmask]
******************************************************************

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