> Baby was discharged from
>the hospital at 9lbs. 6oz. and peds wasn’t worried.
>
>
>
>Mom called me on day 9 and I saw her on day 10. Baby had got down to 9lbs. 2
>oz. and had crystals in urine and no poops for a few days.
This description does point to a need to check
the effectiveness and frequency of milk transfer
ie 'is this baby getting enough milk? ' I
agree....but if the baby appeared healthy, I
would respectfully wonder at the justification
*at this stage* for intervening beyond observing
the feed, adjusting attachment/latch if
necessary, and checking the mother is feeding in
a responsive way and not scheduling or limiting.
You may have investigated all this, sorry,
Barbara, but you did not mention if you did in
your post.
Breastfeeding effectively and ad lib, including
at night, keeping mother and baby close - that
is, feeding physiologically - can turn these
situations round fairly quickly, without the need
for the massive hassle of expressing, using an
SNS, and formula supplementation (not to mention
the health impact of using formula). At least,
I do feel these are massive hassles, and my
experience is that mothers, even the determined
and motivated ones, feel they are massive hassles
as well!
The fact that this baby's weight appears to have
dropped a couple of ounces once she reduced the
supplementing makes me think that there is an
issue with supply/attachment/access to the
breast, that can be masked by the interventions
of SNS, expressing and supplementing.
Would it be appropriate now to encourage
physiological feeding only, with adjustments to
attachment if needed?
Heather Welford Neil
NCT bfc, tutor, UK
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