I posted a couple of weeks ago to do with a newborn (4 days) who was not
urinating sufficiently, and still having meconium.  Mom has 2 older
children (19 & 23).  Baby was 7 lbs 12 at birth, 7 lbs 0 the day I saw
them.  She had had blood incompatibility jaundice and had been under the
bili lights.  Mom had nursed for colostrum, but also baby had had
several formula-feeds (about 10 cc's per feed) because she was told that
the baby would perspire too much for the colostrum to compensate.

I told the mom about breast compression, feeding as often as possible,
even if baby asks for it more than every 2 hours...etc.  She says she
did all that, and by 4 days later, baby had re-gained 3 oz.  The
district nurse told her to put her on a 3-hour schedule in the day, 4
hours at night.  :-(  3 days later, baby had re-lost the 3 oz.

They've been supplementing with a bottle ever since (a Playtex
disposable bag system kind), about 1-2 oz after each feed.  Baby usually
takes 20 minutes per side, empties breasts well (softening of breast
noticed), and then they try and put her down...more often than not she
is awake within 10 minutes "wanting" her supplement.  Sometimes she
refuses it, sometimes she takes more nursing at the breast.

Now that she's supplementing, she has to wake the baby after 3 hours to
nurse.  And she says "wonder of wonders, I can actually put her down for
20 minutes now; she doesn't constantly want to be in my arms like
before".  Luckily, as an older woman with lots of time on her hands,
she's not against picking up the baby:  baby would not have been left to
cry it out, I don't think...but she does like a bit of freedom, or so
she says.

I had mentioned to the mom the last time I talked to her about
supplementing with a tube at the breast.  It has taken me until today (5
days:  had to get it sent in by snail-mail!) to GET the tube here in the
boonie-towns where I live.  :-(  I just got off the phone after about
1/2 an hour with the mom.

Mom discussed supplementing with the tube with her husband (baby's dad)
and he wants to keep his feeds with the bottle for closeness.  I asked
if he was interested in giving the baby her bath.  No he's not.  :-(  I
suggested she might want to use the supplementing tube (french #5) for
HER feeds, so that the bottle is only ever given by dad (HOPEFULLY
causing less of a risk of nipple confusion).  She will think about it,
but I highly doubt she'll come back to me for this.  I loaned her a
sling, which she says she tried but didn't like, and doesn't want me to
show her how to use it.  I reminded her to call me if she needed me
which she has always said she would do, but so far hasn't called me
(I've always called her back).

Mom enjoys seeing her company (including her grown children) give the
baby the bottle for "their turn" (after her turn).  And she admits that
this is her security...she knows that baby takes in 1-2 oz after most
feeds.  Says if baby has re-gained a good 7-10 oz by the next weighing
(which I think is tomorrow) she might try and eliminate some of the
bottle feeds and become more "militant", but she fully realizes that
there is a good chance that the baby will go more and more towards the
bottles.  I learned also today that her goal was originally to nurse 3
months, that is how long she nursed the older 2...but she said she's not
"that hooked" on nursing that if she can't for 3 months she'll have a
mega-depression.  I think she'd be more likely to get depressed if baby
has lost more weight, but "oh well, the supplement is there to pick up
the slack".

She thanks me for the call-back and the support, but she says she'll
call back IF she wants to learn how to use a tube to supplement.  Which
I doubt she'll do.

I can't quite figure out why she didn't go back to feeding frequently
and that stuff after the baby lost weight rather than supplementing, but
I didn't want to ask either over the phone.  If I'd been in person,
where body language, facial signs, etc., can be seen, and I could say
that I wasn't trying to pass a judgement on her, or anything, I was just
curious...maybe...but over the phone, I didn't feel comfortable asking
that.  I also can't quite figure out why her daughter, who is one of my
friends, who was THERE when they saw the weight-drop, and who KNOWS that
I know more about nursing than a lot of the paediatricians around here
(NB this is not saying all paed's, ok?), didn't give me a call to say
"hey, what can we do here, where can we go from here?"...but it's a bit
late now.

Anyhow...what more can I do, short of knocking her door down (which I
don't want to do)?  The #1 rule has been followed:  baby is being fed. 
Baby will not starve to death even if mom slowly gives more and more
formula.  I mentioned herbs (fenugreek, oatmeal, fennel, etc.) but
didn't even get an interested "huh" out of that.  I feel as if I've done
what I can but it's her duty to come to me to ask for help.  I feel as
if I've failed at helping her...I should have called her back earlier, I
should have pushed more...but then maybe that would have been worse and
more "attack-like" from her perspective.  :-(  I KNOW that if she were
interested I could get her back nursing fully, given the small amount of
supplement she's been giving.  It would be rest, nurse every time you
possibly can, pump in between, use the french #5 tube to
supplement...but the interest seems not to be there.

Saddened,
Fiona
ressource person with Allaitement Québec
Mama to Sandrine Leïlou, 13/03/00, nursling toddler.

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