Ask if diapers are soaked or just damp. First time moms often don't
realize that "# wets" means really wet. If they're having to pull a diaper
apart or put a tissue in to tell it's wet, then it's not wet enough to
count.
Also ask if baby is sleeping alot, and has to be waked up for feeds.
"Sleepy baby" is often the first sign of bili creeping up, then becomes a
vicious cycle of sleepy baby > decreased intake > bili creeps up > sleepier
baby > etc.
Regarding lenth of feedings, ask length of time baby is actively
swallowing, not just at breast.
One hospital I get referrals from has begun teaching breast compression
routinely to all new moms that have babies that could be at risk for
problems: medicated labor, slightly premature, primip, etc. Having fewer
problems now!
Becky Saenz, MD, IBCLC
Jackson, MS
At 11:48 AM 11/20/99 -0500, you wrote:
>I am again seeking some information from all wise participants of this
>list.
>
>In the past 2 weeks we have had two newborns readmitted to the hospital
>with quite high bilirubins. Both infants were 5 days old and had bilis
>of 25 and 27. (Ironically both infants had the same pediatrician)
>
>It is our practice to call moms 2-3 days after discharge, just to see
>how things are going. We were unable to speak to one of the mothers but
>I did speak to the other and with the exception of stools not turning
>yellow by day 4, things sounded as though they were going well.
>( she made no mention of the jaundice) Ironically, the infant was
>admitted the very next day.
>
>I am wondering if we are missing something. We ask about:
> # of wet diapers in 24hrs
> # and color of stools in 24 hrs
> # of feedings in 24 hrs
> length of feedings
> any supplements
> nipple soreness
> breast fullness
> audible swallowing
>
>I talked with the neonatologist about how the number of voidings and
>stools were what we consider to be wnl (voids 3-4 day 3, 4-5 day 4,
>stools 2 or more). He said that probably amount was not sufficient and
>ofcourse his suggestion was supplementing with formula any baby that
>didnot settle and sleep after nursing.
>One of the infants they feel was very dehydrated with weight loss of
>about 1# from birth weight. Other baby had an admission s/g of 1.005.
>
>Anything else we can ask with our phone calls to identify problems?
>Sorry about the length of this posting.
>
>Judy Hatfield RNC IBCLC
>
> ***********************************************
>The LACTNET mailing list is powered by L-Soft's renowned
>LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
>mailer for lightning fast mail delivery. For more information, go to:
>http://www.lsoft.com/LISTSERV-powered.html
>
***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html
|
