Ready for this one? I've been swamped lately and I'm going in for major
repair surgery on Friday (5/12)...here's the latest. I have been seeing a
mom whose baby lost about 9% of bw and has been slow to regain. At 14 days,
the ped told mom that wt gain was too slow so she'd better supplement with
formula in a Platex nurser no less. Mom called me and said that baby wasn't
a good nurser and only fed for 5 minutes, then fell asleep. I examined mom
and baby at 21 days. This is a full term, otherwise seemingly healthy baby.
Mom appears to have ample milk supply and already was using breast
compression, although no one had instructed her to do so (this is baby #2).
Upon examination, it appeared as though mom's assessment was correct. She
added that baby hated the bottle and spit the nipple out (smart baby). Oral
exam and suck assessment showed baby had shallow palette and strong gag
reflex, plus tongue thrusting. I discuss infant massage with all new
parents, but esp with slow gainers or hypertonic and "colic" cases. When I
was demonstrating the "I Love You" pattern on the tummy, this baby was chock
full of tiny gas bubbles. As it turns out, mom has thought baby had
terrible gas, but couldn't get burps out. I recommended simethicone (in
particular, I use Phazyme because it lacks red dye). Mom just called...The
baby's been actually passing the gas, as well as productively burping. The
baby is chowing down like there's no tomorrow. This baby was filling up
with little air bubbles and had no room for milk. We still have some latch
work to do (the bottles have exacerbated the tongue thrust), but I am
furious that this doc never even investigated the possibility and just
pushed the formula and even recommended this type of bottle/nipple. This is
an MD who calls himself bf-friendly too. Thanks for listening to my
(latest) rant!
Warmly,
-- Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
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