Hello again, thanks for the input on peppermint tea last week. This week
we have a bigger challenge.  9 day old male infant with birth weight of
7lbs,8ozs whose mother is concerned due to fussiness at breast.  Weight
of babe has continued to drop since birth to now 6lbs,10ozs. On
inspection, the breasts are full and leaking, lactogenesis occuring on
day 3, mother describes q3h feeds, appropriate numbers of wet diapers and
stools, urine clear, etc.  Observed at breast: Latch score of 10, perfect
feed until letdown occurs at which point infant gulps several times,
comes off the breast to breathe and resumes feeding repeating scenario
over and over - gulping, coming off to breathe, returning to feed. Infant
also had a raised red, solid rash over torso, afebrile. Moist mucous
membranes, moist warm skin with good color.

Mom is using a pacifier between feeds, drinks lots of cow's milk. I
suggested she see pediatrician that afternoon, to feed q2h during the day
,q3h at night. Suggested a 10 day trial of avoiding cow's milk in
maternal diet. Get rid of pacifier. Return tomorrow for weight check.

Pedi saw babe and says babe has a mild otitis, is treating with oral
antibiotics and has taken over the followup.

My concern is that, in speaking over the phone with mom today (now 4 days
later) her baby has lost another half an ounce, will be 2 weeks old
tomorrow and is now almost a pound under bithweight. I phoned the pedi
who doesn't seem to be too concerned.
 He says we just have to manage this feeding problem. And I'm wondering
if we have a malabsorption problem, I don't know. Any ideas? though the
followup is in his hands. I'm just really concerned about this kid.

TIA, Katherine Abdun-Nur