The mother of a baby born with spina bifida and operated on with a drain
called me two days ago. She has been pumping for the baby since birth
(baby is 4 months old), to supplement if needed. Baby finally was able to
have adequate weight gain for 14 days, when he stated to be fussy and
hungry again. His urine went down (Momn catheterizes), and she notices a
fall in the quantity of milk pumped. So, she supplemented with EBM, with
bottles or syringe or cup, depending on time she has and humor of baby
(he definitely does not like syringes and cup...) Takes the breast well
and vigorously, but not satisfied. I reminded Mom to pump at least 8
times a day, at least 15 minutes at a time, suggested positive
visualization and to contact LLL in order to talk to other Moms that
pumped their sick babies for a long time, to explore ways to deal with
these unexpected "strikes". I will call her tomorrow to suggest lots of
skin-to-skin contacts. Mom lives alone, no money. Support occasional
from her mother. Nurse visits every other week or more, on demand, but
Mom wont ask (leary of professionals...). What else could I suggestto
this Mom who already has gone beyond the call of duty (she knew before
the birth that the child was special, and opted for loving him, ratehr
than getting an abortion... crazy, huh ? some people would call her
irresponsible. But, maybe I am extraordinarily naive, but I find this
woman admirable, and would like to help...)

Louise Denhez, M.D., M.P.H
Chargee d'enseignement clinique
Departement de medecine sociale et preventive