Well I would look at several things. I definitely would expect a baby of 2 wks old to be gaining weight steadily. My approach would be to get a careful history. How did things get started in hospital? How often does baby feed? How long do feeds last? How saturated are the diapers? What exactly were the weights, etc. In the vast majority of these cases, it is not a sepsis type illness, most often it is a low intake problem. I would try to do some pre/post feeding measures. By a quick calculation, baby needs about 656 ml per 24 hours. That would be about 65 ml in 10 feeds per day. Baby could take a little less if he feeds 12 or 14 times; he would need a little more if he only feeds, say, 8 times. However, if baby is only taking in, say, 45 ml for each of 8 feeds, he will be coming up quite short. **Disclaimer** Thriving infants do not need this kind of mathematical measurements.
I would use "switch nursing" and breast compression. I would want to see how mother's breasts are feeling now, pre and post feed, and I would want to know what her experience was around day 2-5 when her milk should have "come in full." I also would want to know what the serum bilirubin levels were, hopefully they were measured.
I am guessing that this baby is taking in less than he needs for growth, and if mother's supply is abundant, which I seriously doubt, she can easily supplement with her own milk. However, if her supply is low, which I'm pretty sure it is, then this is more difficult, due to the fact mother does not wish to use artificial milk. I don't blame her for this, however one is never sure how long an infant can go with underfeeding, and what harm might be done. I think mother needs galactagogues quickly, then, and maybe "power pumping" for several days, in between feeds if she's able. Perhaps if these tactics do not work, some elemental formula can be used, briefly, or preferably donor milk. This dyad need continued close monitoring and support. Laurie Wheeler, IBCLC, MN, RN Mississippi, s.e. USA
_________________________________________________________________
Invite your mail contacts to join your friends list with Windows Live Spaces. It's easy!
http://spaces.live.com/spacesapi.aspx?wx_action=create&wx_url=/friends.aspx&mkt=en-us
***********************************************
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]
The LACTNET email list is powered by LISTSERV (R).
There is only one LISTSERV. To learn more, visit:
http://www.lsoft.com/LISTSERV-powered.html
|
