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Subject:
From:
Lynn Shea <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 24 Oct 2001 10:30:58 EDT
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Jan writes;
>> what I'd like to know is if there is any particular standard upon which
LCs determine a baby w/ FTT needs to be supplemented.<<
I don't know if there is any particular standard and I would worry if we
relied on "one" because the variables can be so very different. Most often, I
adjust the amount of supplement to allow for the very frequent feeding
necessary to increase the mom's supply (we have ruled out all other factors,
thus we know it is low) and to make it workable for Mom. Obviously, if we
have a baby in crisis mode, the issue of increasing supply becomes second to
immediately improving intake and visa versa.

>>How do you work w/ a baby that is FTT that needs supplementation for a
period
of time?<<
The management differs from case to case. I have one Mom that I am currently
working with and have been for about a month (I posted to Lactnet about help
with managing), whose baby was below birth wt. at 1mth, looking very
malnourished, she with very low supply (probable lack of glandular tissue)
and now continued issues with supply. She had been supplemeting with an SNS
(totally at first then more and more bottles) until about a week ago when she
stopped the SNS and consequently nursing entirely and is now pumping 5x/day
and bottle feeding. We were able to up her supply somewhat with the normal
measures including fenugreek and finally reglan (she wouldn't try
domperidone) but I figure the baby was probably taking 1/2 and 1/2 at the
peak of her supply. She is now pumping 10oz. of the 30 the baby takes each
day. He has gained 7lbs. !! in the last month!! (which DOUBLES his weight
from 1 month) and looks normal!! On first consult he was IN crisis mode but
because he was very vigorous, thus willing to eat, and I felt that the
feeding adequacy could be improved quite a bit (and because this Mom was very
reluctant to suppmt!), we tried two days with improved fdng. effectiveness
and very frequent feeds. His weight stayed the same and at that point I
convinced her to suppmt. BUT the suppmt amount was adjusted to allow for very
frequent feeding at the breast.
In retrospect, I would have suppmtd earlier but in other instances I have
seen babies "take off" with seemingly minor changes in positioning.
Great discussion topic!
Lynn Shea Rn,Bsn,Ibclc
Franklin,Massachusetts- off to help out at my baby's (almost 7yo :( ) school
and then play tennis in the cont'd 70 degree weather!

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