Hi, Lisa - I would be concerned about the milk dribbling out of the baby's mouth - could be a sign that suckling isn't very effective. You should be able to hear a 'kah, kah, kah' sound if the baby is swallowing (although not necessarily).
Have the mom try reclining positions (on her back with baby face down on her chest). The baby will be able to achieve a deeper latch and use his tongue more effectively.
Check out this LLL tearsheet: http://www.llli.org/docs/0000000000000001WAB/WAB_Tear_sheet_Toolkit/01_laid_back_breastfeeding.pdf
Ideally, moms would spend 24/7 skin-to-skin with their babies for at least the first few weeks, but that's a mental shift many people in Western cultures just can't make.
The red bum could be a sign that diapers aren't being changed very frequently, which may mean that there are actually more wet/poopy diapers than reported. And of course, every time there's a poop, there's also a pee.
Re test weighing, from Breastfeeding Answers Made Simple:
One test weight is NOT enough information to gauge a baby's 24-hour milk intake... doing test weights around the clock (for 24-48 hours) provides much more information.
...the amount of milk [babies] consume at one feeding will vary by hunger and time of day [just like adults!]... Daily [over 24 hours] milk intake among healthy, thriving can vary by as much as THREE FOLD.
Research has found that the baby scales typically found in healthcare offices are not accurate enough to assess milk intake at the breast. Only scales accurate to at least 2 g (0.1) ounce are precise enough for that purpose.
To get an accurate estimate of milk intake, the baby must be dressed identically during before and after weights. Milk dripped onto the baby's clothes either from dribbling during feeding or milk leaked onto the baby from the other breast will also throw off the weight. The extension of a blanket or a baby's arm or leg over the side of the scale basket is another variable that can affect the weight.
Most small babies find being weighed much less stressful if they are placed on the scale basket tummy down.
On another subject, what the heck is 'PTP'?
Ingrid
La Leche League Canada Leader
International Board Certified Lactation Consultant
-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Lisa Paul
Sent: Tuesday, February 21, 2012 8:57 AM
To: [log in to unmask]
Subject: stalled weight gain
PTP
I am a peer counselor working with mom and 2.5 week old baby. She is also working with an LC, and her pediatrician.
Baby seems to have stopped gaining weight.
2/2 Baby@ birth 5lb 4oz
2/13 5 lbs 9.5 oz (ped office)
2/15 5lbs 6oz (WIC office)
2/16 5lbs 6 oz (ped office)
2/21 5lbs 7oz (WIC office but had diaper on.)
Mom reports 5-7 poopy diapers a day, and 3-4 wet. Mom reports redness on bum.
Pediatrician was not concerned last week about lack of weight gain, because baby is back to birth weight. Mom is not scheduled to see pediatrician again until 3/2. (But plans to call about latest weight check.)
All the signs indicate that mom is producing milk - I hear swallows, I see milk dribbling out the side of baby's mouth, the poops are happening. Mom spent her weekend breastfeeding and is concerned that there is no weight gain. I am concerned as well.
Mom asked me to post to find potential reasons for this stalled weight.
*I* am asking for help in working with this mom - should I be concerned? Do I need to be raise a red flag and just how intense is this situation? This is the first time that I have offered weight checks to a mom and she actually took me up on it, and now I am looking at a situation that isn't just a confidence-building weight check.
Thank you!
Lisa Paul, ICCE
Breastfeeding Peer Counselor
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