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From:
Riva Weissfish <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 15 Apr 2010 10:36:38 -0400
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I apologize in advance for the length of this post, but I felt that the details are important.
I have permission to post.
I would like your input in dealing with a problem I saw today.
I work in a facility where women come to recuperate after birth. The mom I saw today was referred to me by the nurse because the baby had a sudden weight loss of 110 gram. His birth weight on 3/24 was 3.580, d/c weight was 3.410. On 4/11 he weighed 3.960. On 4/14 he weighed 4.110. Today, 4/15, he weighed 4.000. I reweighed him to see if perhaps there was a mistake and came up with 4.010( he had started eating a bit) Baby was born in an uncomplicated vaginal breech birth.

This baby is indeed tongue tied but is not causing any pain. The mother complains that he falls asleep after 10 minutes of eating with his eyes closed.  * What is interesting is that she reports that during the week at home he ate every 2-3 hours, was peaceful and seemed satisfied, waking spontaneously and gaining weight nicely.   *     Today, he was refusing to close his mouth on anything: not breast, not bottle not finger (This also was a sudden change). He cried  tried to latch and cried. I could not do any sucking evaluation, thought to try suck training but could not get him to suck on the finger. I had her go to her quiet, darkened room and stay sts and he did settle until she tried to feed, one or two sips and he started to scream.

I had a hunch; could he have been sensitized to milk? He has received some dairy supplemental formula feeding and mother eats "just dairy" – 2-3 weeks is a time that this could start to be seen.

But what about the TT?  If it were the problem wouldn't the weight loss be gradual and the problem develop? Is it a red herring? Perhaps the baby being in the noisy and light nursery and having to wait until Mom is called (and in the meantime crying to despair) effected his feeding?  What about the sudden and drastic weight loss. I could not explain that with either of my theories. I considered suggesting CST but his first week of life he seemed to do well.

I left her to do lots of STS, keep her baby in the room, breastfeed as much as possible, pump and try to feed with bottle if necessary (she would not be willing to cup, spoon or tube feed) , if she must give formula to use soya temporarily and to make dietary changes appropriate to my hunch. But, this baby has to eat. What if he continues to lose tomorrow as well?

I would greatly appreciate some insight to help me sort this out.
TIA,
Riva Weissfish BA, CCE, IBCLC 

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