Hi Tricia,


I would be working with the idea of a baby who was IUGR will be "catching
up." I am very generous with volumes, the baby takes the lead and often
these babies seem quite hungry. I do agree with you that parents want/need
some kind of guidelines. Full term babies gear up to around +/- 30 oz (900
mls) per day in my experience. Your client's baby could easily be taking 50
or 60 mls per feed, and then more, as baby is gaining along.


I would reassure the parents that the baby is not obese, he needed to catch
up, and that the early fast weight gain was appropriate, and that the daily
gains will likely slow down to average.


If the baby becomes an obese child, who knows? It could be a factor of the
IUGR situation or other eating/activity habits. I would reassure mother
that she is responding appropriately to her baby's cues/needs and that when
she notices 90 mls is a bit much, then she can back off a bit as she's
done. Great job Mom!


Laurie Wheeler RN MN IBCLC

Mississippi USA

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