Hi Isabella,
Heather has already made excellent points. And I agree with her. It sounds
like bf was (for lack of a better term) sub-optimal in the early days.
Perhaps baby was sleepy, mom was in pain, latch was less than perfect (sore
nipples, although mild). Did she get any contraceptive p.o. or injections?
What I recommend is to assess mom/baby in person as Heather suggested. Then
schedule close follow-up, I usually go 24 to 48 hrs, depending on what my
assessment showed and how underweight the baby is. The same scale and the
same person weighing is ideal. This baby is not far under, but it is 18 days
out, which would concern me. The pediatrician is probably not worried becoz
baby is not far underweight, but if conditions are not favorable for milk
intake, the baby will likely lose more weight over the next 3 days, and time
would be lost. So I personally would not be in favor of the plan to keep
going and return in 3 days. I would suggest to the mother an alternate plan
and the reasons why, and speak to the dr. if I needed to as well, to explain
why.
If mother has a good supply at this point, and you assess baby can latch
well or you can fix the latch, then mom can be advised on frequency and
effectiveness of fdg, breast compression, and the like, and give them a
couple days. But, if supply is low, then supplement might be needed. If baby
is ineffective, but mom has enough milk, then expressing post-feed and
comping with alternate feeding method may be enough, depending on how much
mom can express. I see you've assessed the latch and suckle, so I would
think mom's supply is just low right now, with a slow flow, and needs
increasing with frequent feeds, post-feed expressing, and galactagogues are
ok too.
Laurie Wheeler RN MN IBCLC
Mississippi USA

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