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From:
Price Pamela B <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 17 Feb 2004 10:13:38 -0600
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Dear valued colleagues,
My last post is exactly why I love Lactnet and value it so much. Thanks for
your suggestions.  As for the weight and growth, I really did not feel she
should be concerned, everything that I found only confirmed a normal growth
pattern.  I wanted to make sure I was not missing anything (obviously I was
missing the allergy thing). I will let you all know how it works out.
  The dad was a small baby (according to relatives) and mom and dad are both
small-medium height and build.
 The baby had gained 16-20 ounces a month from the first month until the 5th
month. It was not until the 5th month that the baby's gain slowed to 11
ounces. He doubled his birth weight in 6 months.( his discharge weight from
the hospital at 48 hours was 6lbs)  I had not thought about the allergy
aspect.  This baby definitely has a history of food allergies, the reaction
baby had last week was more of an obvious reaction, hives, rash and
vomiting.  I did not think about the possibility of allergies causing slow
gain but that makes total sense to me, and if the baby is not able to
metabolize all of the foods that he is taking in then it will not help to
add calories in that area.  When I got really technical about the calorie
intake, (which is impossible but since the pediatrician was so adamant we
gave it a shot... and guestamated)  If the baby takes in an average of 3-4
ounces each feeding, and nurses on average 7 times during the day/evening.
Then calories from breastmilk (if all calories were the same, then the baby
would be taking in approximately 21-28 ounces/ 420-560 calories.  If then
the baby nurses throughout the night, the baby would need to take in between
4.5-11 ounces.    The feeding that I observed the baby took in about 3
ounces and this was an "in between" feeding.  The mom is what I call a
"natural breastfeeder" she nurses the infant for feedings, when he fusses,
if he is tired, whenever he wants to nurse for whatever reason, without a
lot of thought to it (as it should be)  She only began counting his feedings
when the pediatrician told her that her baby was not thriving well enough on
breastmilk.  She does not count all the extra times that he goes to the
breast as a feeding.  Breast compression is something that mom does as he
nurses.  And he would eat almost anything that is offered to him however
often, he does not eat non stop, he does limit himself, when he is full he
just turns away signifying that he is done.  Mom has not forced any feedings
on him, if he does not want it, she does not give it.
Now that I have heard from some of you, I am going to suggest that she try
just nursing alone for a few days, although baby does like to eat, so is
there any suggestion as to some foods that are not as likely to be
allergens? Or should she just decrease his table food intake?   On Friday
when I saw her I had suggested that she start meats, instead of all the
veggies and fruits, because the meats are higher in calories and protein,
but then I read that there are studies that show that an increase in protein
intake did not increase the weight gain overall.  That also makes sense to
me if the baby is not able to metabolize the protein in the meats and
utilize them as well as in the breastmilk.  And even with the increase in
calories over the weekend, he did not gain anything.

By the way... I watched this baby spit up, it is the oddest thing, he does
not even burp or make a sound, it just comes rolling out of his mouth, even
when he was nursing once.  It was almost like he overflowed, did not stop
him from going right back to nursing.    I thought of reflux but this baby
never acts uncomfortable.  He does not even cry out, just giggles and smiles
as it all rolls out.


And just to add to all of our frustration with unsupportive providers, when
mom asked the pediatrician, would her baby could be so happy, never sick and
so active and advancing  if he were starving, the pediatrician responded "if
he was never use to getting enough he would not know what it's like to be
really full"  What kind of response is that?     Mom is frustrated by what
she calls "the lack of common sense" of the doctor.

Pam Price IBCLC, CBE
Lactation Services Coordinator
Women's Health
Trident Health System
9330 Medical Plaza Drive
Charleston, S.C. 29406
(843) 824-5013 office
(843) 728-9640 pager

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