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Subject:
From:
"Robin Roots,Rn Ibclc" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 7 Feb 2008 16:55:24 -0500
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When I absolutely must tell a mom what to expect for weight gain/loss when 
they are being discharged from the hospital, yes we HAVE to go over 
discharge instructions with each family, rightly so.  And yes you can see why, 
the hospital must cover themselves, I generally tell them once their weight is 
back up to birth weight, they can expect to see a gain of around 4 - 8 
ounces/week.  Babies almost always are below birth weight when discharged 
because its before the "mature" milk is in. Being discharged on or around day 
2.  Of course their are exceptions to every rule.  But because we get "pinned 
down" to a number from most parents I think thats a fairly safe and accurate 
amount.......At least in my experience.  New parents do need to be aware 
when their babies are NOT thriving.  Sometimes, we do need to emphasize 
that their 5.2 lb 37 week baby needs to be reminded to eat.  I don't ever like 
to see babies get readmitted because parents weren't informed of a baseline 
number or looking for wet or poopy diapers.  When working with the public you 
must cover your bases for the babies sake.  And hospital protocol.  I once had 
a mom call me out of the blue,(i don't even remember how she got my 
number) as she was driving around my area of town.  It was a friday, i will 
never forget it.  She was concerned her baby was not satisfied at the breast 
and was always hungry and crying or sleeping....okay, little red flag,... I asked 
her when she last saw the peds, she said today.  Well,  " how much did your 
baby weigh?  The amt she told me and the amt the baby weighed meant the 
baby was a complete pound under birth weight at one month old.  yikes, I 
asked her if she wanted to come by and I would weigh the baby myself, and if 
needed  call her pediatrician.  Low and behold, this poor little baby was indeed 
failing to thrive.  The staff at the ped clinic did NOT pick up on this and told 
her to come back next TUESDAY 4 more days for a f/u weight check.  Long 
story short. Mom had severe hypoplasia, we immediately gave the baby some 
abm, I swear she smiled at me, and I called the doctor and politely informed 
her what had just happened in her office.  She was back at the Peds within an 
hour/ saw the Pediatrician in person.  Thank goodness mom's instincts kicked 
in.  She had just been assured all was well. This was one case that obviously 
fell thru the cracks. And I won't name the ped group.  I don't know if this 
baby would have made it till tuesdays appt.  So, for the most part parents 
can worry quite excessively, I understand.  But in my experience, guidelines 
must be given.   

robin

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