Hi Seema,
I definitely see babies urinating and stooling "well" (which means within
normal range) during the hospital stay; typically our hospital stays are 1-2
days, even a mom with a c/s birth often goes home in 2 days.
Therefore, the baby is not typically taking in large volumes and is
typically making 1 or 2 pees/poops each day. This is within the normal range
and so the baby is not in trouble - yet.
Even the mothers will tell me, "but he is peeing and pooping real good" when
I attempt to schedule a followup visit for them. What I see alot and what I
tell mom is that the baby is often sleepy the first day (hospital births)
and not very demanding, and using very little calories particularly if we
are doing skin to skin. The baby has some reserve if he is born well
nourished, and so usually has good output. Even if we see "brick dust"
urine, we consider this within the normal range on day 1-1.5.
But I let mom know that it is in the next several days when baby should
begin to noticeably consume more milk and have alot more diapers to count.
The black poops should change to yellow and the pee diapers should be fairly
heavy; you can tell it's wet with your eyes closed.
It is hard to let a mom know that she may have some trouble with her supply
or her baby, but ethically I feel I must forewarn her if she may be lost to
followup. If it's a primip, I can just go with the idea that until the milk
comes in and we see everything going well, and check the baby for juandice
which peaks day 4-5, we need to do a followup. And that most babes lose wt
in hospital and we want to see if baby "turns the corner". If the mom is a
multip, she likely had problems before so you can go from this angle. "Since
you had difficulty with your previous lactaiton let's do an early followup."
If she says her milk never really came in with her previous baby, you can
say "then let's do an early f/u." If the baby's a premie or near term
infant, go from that approach that baby needs early f/u and is more likely
to have juandice.
Once in a while I get a mom who just believes everything is going great, and
it's not, and unfortunatley she needs to be convinced to come in for
checkup, and usually the baby is in some trouble. I don't like to be the
messenger but I must be.
Hope for the best outcome but do schedule early f/u for any and all dyads
with risk factors. If you or another LC will not be doing the f/u, I would
inform the doctor that in your opinion this dyad has some definite risk
factors and will need an early appt. You can at least do a screening phone
call if you can, which often identifies the need for an immediate appt.
Laurie Wheeler, RN, MN, IBCLC
MISSISSIPPI, USA

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
Mail all commands to [log in to unmask]
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or [log in to unmask])
To unsubscribe: unsubscribe lactnet or ([log in to unmask])
To reach list owners: [log in to unmask]