Dear Friends:
I am at a loss and could use some ideas and suggestions for this mother.
Mother contacted me on her baby girl's 9th day of life. Baby had quit
nursing the night before. Just quit. Would go to breast, lick, root, and
refuse to latch. Up till then, all was great. Baby was back to birth weight
by day 5!
Cesarean section, no hemorrhage. No heavy lochia or cramping. Mom at
home. First baby. Family support: husband, and mother. Nobody sick.
No history of thyroid trouble. Latch could be better, but was working
great for 8 days. No breast surgery or problems in the past.
At the home visit, baby would not even bottle feed well. (Breasts felt
firm, but not overly full.)That alarmed me, and I recommended immediate
pediatric intervention. She also rented a hospital grade pump with a double
set-up.
The next three days were spent at doctor's offices, and local hospitals.
Negative for everything. "Baby is fine" ....except the milk appeared to have
vanished. Mom got nothing but drops at the pump, never any engorgement or
fullness.
Mom not pumping: 1-2 times a day for the 4 days from my visit. Mostly
because she was in waiting rooms. Finally she started pumping frequently: 6 x
in a day. Still barely drops of milk coming out.
Another home visit...milk readily available with a bit of hand
expression. Tried nipple shield. It worked! Baby back to naked breast within
2 days, nursing "all the time" plus mother pumping and still getting
basically nothing.
Then, (4 days ago) mother sick with some sort of throat and ear sickness.
Back to doctors for mom, only by this time baby only wants breast, and fights
bottle. Mom in bed, barely able to talk. Describes baby at breast "all the
time" so I stop encouraging pump use. Nipples feel okay, except after an hour
of constant nursing.
Yesterday: mom finally can talk. Baby either asleep, at breast, or
crying. Baby hasn't pooped or farted in 3 days. Baby has been receiving some
formula, as mom too sick to bf all the time. I advise increasing formula
supplement, keep baby at breast and get to peds ASAP. Baby's cry sounds full,
baby peeing, baby only wants breast.
I will find out today what the peds says. Meanwhile, I am stumped. Where
did the milk go? What do you all think?
Warmly,
Nikki Lee RN, MSN, Mother of 2, IBCLC, CIMI
craniosacral therapy practitioner; childbirth educator
Elkins Park (a suburb of Philadelphia, Pennsylvania; northeastern USA)
supporter of the WHO Code and the Mother Friendly Childbirth Initiative
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