That baby is not on the Ezzo program, is she?



Larisa Walk

California



-----Original Message-----

From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Marilyn Fergus

Sent: Wednesday, November 10, 2010 2:25 PM

To: [log in to unmask]

Subject: use of sns



Wise Women 

 I was called to see a baby in peds who was admiited for failure to thrive. Baby is 3 months old and was 6# 13oz at birth then dropped to 6# at discharge.Is now 9#10 oz. Dr. admitted the baby due to a weight drop form the 10th percentile to the 5th at the last visit. I have graphed the head circumference which is at the 50th and the lenght which is at the 15th percentile. ON the chart the weight in percentile is between the 5th and the 10th but still is not linear but  curving up slowly. I know how much you all love growth charts!

The baby is active alert, smiles coos and is peeing and pooping. Baby is irritable and fussy when alot of people are in the room and at itmes hard to console. MOther says this rarely happens only when there are alot of people .

The mother says the baby would rather sleep than eat and is sleeping through the night 7 to 8 hours. the baby will also go without eating for 4-5 hours when they are in the car or shopping she does not wake the baby to eat when they are out.

MOtheri s very tense abut feeding infront of other people  and says the baby will not eat when others are around. Dr. staarted having her give 10 mins on each side and then a 2oz bottle of formula. Baby has treacheal malacia, mother is being told that the baby is worikng too hard at breastfeeding and that is why she is looising the  weight. Breastfeeding is too hard for the baby.

So when I went in I watched the mother feed adjusted the position so the baby's head tilted back just alittle farther no sound was heard except the swallowing. baby was fine at the breast untill mother and I started taking. Then the baby became fussy and pulled off the breast. We stopped talking, I left and the baby continued  tobe fussy.

These were the suggestions that I made.

 1. to wake the baby during the day not to go longer than three hours without feeding letting the baby nurse frequently even of closer that 3hours.  Mother has been giving a pacifier if the baby got fussy. Told her to just feed the baby  instead.

2. Mother feels that her breast aren't as full as they were so suggested that she pump after feeding the baby ,or power pump in the morning and at night.

3. Spoke to her about herbs to increase her milk supply.

4. So as to please the peds set her up with a supplemental feeder so the baby would stay at the breast get the extra formula without getting a bottle.

5. Suggested that she follow with the LLL or our new mothers group to do weight checks each week. 

6.. Asked about her diet she is a vegatarian so I suggested that maybe she sould increase her protien intake and fat intake .

&. Asked about any medications or birth control pills, or any antihistamine intake that might decrease her supply.Was still taking her prenatal vits. no other medication

Here is where it got messy!

Peds went in and told the mother that SNS is only for newborns and that givnig the baby a bottle of formula would be better.  The bottle would not in anyway interfer with her nursing.

That breastfeeding was not enough for her baby. We had tried a test weight at one Breast session however the nurse on peds said they were not very accurrate and never rechecked the weight. 

I had the mother pump at one time and she did only get 3 oz. however this was late in the day. The mother says she can get up to 6oz total at times. 

The final answer to this mother by the peds was that the baby was not getting enough food. She needed to supple ment with a bottle and that breastfeding was too hard for this baby because of the treachea malicia. That no baby at 3 month shoudl be sleeping through the night. She needs t feed this baby every 3 hours

so What do all or any of you think I missed? Beside suggesting that she get a new peds. Maybe some what?

All of the blood work they drew looked fine normal labs.

Just give me some suggestions.



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