Hi Debbie,

I have just recently learned from our neonatologist here in Sudbury that it is quite normal for
hgb levels to drop quite suddenly in this way in both term and premature babies at about 6
weeks.  This is the time that perfusion of the bone marrow and general periphery kicks in and
the low hgb helps to kick-start erythropoetin (sp?) production and the babies start "reticking"
on their own (I'm probably not explaining this accurately).  This is why our neo is quite upset
when she finds our little prems getting a blood transfusion because of low hgb, always at about
6weeks post birth.  This means that the baby has to wait about another 6 weeks for the hgb
level to decrease again sufficiently (to about 6) to kick-start their reticulocyte production.
She says it often happens that docs decide to look for a "bleed" when they see this sudden drop
(of course this is usually with hospitalized babe such as a prem; with well term babe at home,
this goes of course unnoticed)and subject babies unnecessarily to such procedures as the scope
your baby's pediatrician wants to do.

Hope this gets to you in time enough that you might be able to convince ped to reconsider
scoping.  I'll get a better described explanation for you tomorrow!

Genevieve Courant MSc,RN, IBCLC
Sudbury, Canada