Short summary - telephone consultation on 16 day old fully bf baby, 11 days no bowel
movements, 50 gr. weight gain since lowest weight two weeks ago. No way I could
see baby. I told them to FEED THE BABY with whatever works.
Today - less than 48 hours later - baby got bottle with 40 - 90 ml ABM after every
nursing, has plenty of bowel movements, gained 150 grams! Mom doesn't want to do
anything further, is content to nurse and add bottles.
I haven't talked to the mom, it's all through the nurse who called me.
Later I remembered why the nurse called me in the first place. She wasn't worried
about insufficient weight gain - thought baby was a "slow gainer", she wasn't really
concerned about no bowel movements (This is normal in breastfed babies, isn't
it????!!), she just wanted to know, since 11 days is a bit long - what do I say about
adding a few spoonfuls tomato juice to get the bowels moving. In a 16 day old baby!!!!
I was so concerned when I heard the story I forgot all about the tomato juice. I had to
get it across to that nurse that the baby was STARVING. She just didn't get it, and
neither did the baby's doctor. He also said everything is OK, and come back in 3 days
if there still is no bowel movement.
I think it's only today when she saw the difference, and the 150 gr. weight gain that
she really understood.
How do we get the right message to the HCPs? BF is important, don't give formula or
stop bf for every problem, BUT there are cases when a breastfed baby does NOT get
enough milk - and this has to be fixed, and first of all the baby has to be fed.
I feel a lot better today for this baby, but who knows what could have happened if they
would have gone on waiting for bowel movements?
Mira
Mira Leibovich, MD, IBCLC
Israel
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