Good morning all.
It is 5 a.m. in rainy NYC, and after tossing and turning for the past 2
hours decided to unload.
Had an unpleasant experience over the weekend.
A couple whom I met in my prenatal breastfeeding class was at some baby
event I attended over the weekend. They came over and gave me a hug eager to
show me their 7 week old son.
I took one look at the baby and felt ill.
He had the very distinct look of a severely malnourished baby. Paper think
grey skin. If I were to diagnose, it would be FTT!!! Vigorously sucking on a
pacifier. Asked the mother how they are doing, adjusting to parenthood...
She said, "great! But I think I don't have enough milk". I asked her what
make her think that? Because the pediatrician thinks that the baby is
gaining a little slowly. (How about not at all?)
So I continued to ask about the weight. He was born at 6#14 lbs. Now at 7
weeks he is 7#1 lbs.
Well, I stayed as calm as I could. I asked her what the doctor recommended.
She talked about supplementation. How she doesn't want to use formula so she
is using only a little here and there. Anyway, I won't get into the 45
minutes session I had with her in the middle of this event. Needless to say,
I made it clear, as gently as I could, that her baby needs to be
supplemented every feed. Less pacifier use. Talked about his hunger cues
(which are probably not intact at this point). That if she wants to increase
the supply she needs to pump more often and gave her the protocol plan for
doing all that. Etc.
To make things worse when she sat down to feed him there, I observed a
significant asymmetry of the baby's head. Asked her about his head position
when lying down. She said he can only feed in the football position on the R
breast and the cradle on the L. And that when he is lying on his back, his
head goes all the way down to his shoulder. He can't lie straight. It
matched what I saw. Suggested a visit to a great D.O. I refer to to work on
that.
Well, when I left I needed to go home and sit for awhile to go over
everything and calm myself down. She asked if she could attend my clinic
this week to check up on how they are doing. We'll see if she comes.
Regardless, I think I will fax a report to ped today. I know she didn't seek
my services professionally, but I don't know what she will do next or if she
is really getting it. They stayed a little too cheery for comfort. I now
feel responsible for this little baby and can't ignore what I know.




Ayelet kaznelson IBCLC in NYC.

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