Carrie
I think the jury is still out on whether or not IV fluids for mom will
artificially inflate babies b.wt. However if you search the archives, fairly
recently, I think Barbara Wilson-Clay shared some info from a conference
paper that she heard presented, whereby this was studied and showed no
effect. In my opinion, and alot of others are now thinking this way too,
less of a wt loss for any baby is really the norm, or should be, not a big
loss and taking 2 wks to regain b.wt.
So, to your particular client, that does sound a bit problematic to me
having a 7#10 down to 7#3 (I think that's about a 6% loss) then down to 7#0
(that's an 8% loss I believe) instead of a wt gain at least starting around
day 4 or 5. The percents are not real worrisome but the downward trend is.
Yes, scale differences can occur, but in my experience I have not
encountered this. Now, whether or not the baby needed *immediate* formula
supplementation, if at all, is debatable, but certainly the bf needed
evaluating to see if milk was in, milk transfer occuring, etc. and if no ebm
available and if no direct effective bf was occuring, then maybe so. I have
asked this question several times, and I don't know if there is an answer:
WHICH DOES LESS HARM: BABY LOSING WT BUT GETTING ONLY BREASTMILK *OR* BABY
GAINING ROBUSTLY BUT GETTING FORMULA SUPPLEMENTS? HOW MUCH IS TOO MUCH WT
LOSS AND FOR HOW LONG? WHICH IS WORSE: EXPOSURE TO FORMULA DURING THIS (I
assume) CRITICAL PERIOD *OR* LACK OF ADEQUATE CALORIES/NUTRITION DURING THIS
CRITICAL PERIOD. This is a fine line to walk and is often a judgement call.
This is not a flame: It can be very frustrating to be surrounded by others
not as enlightened as we regarding optimal bf (how superior that sounds) but
I am sure this pediatrician is only trying to do what he/she feels is in the
baby's best interest. Also keep in mind that, if you were not there with the
mom, her portrayal of the encounter may not be entirely accurate. (Have you
ever been misrepresented to an MD by someone?). I think what can work in
these situations, if we can work with the mother (have you been able to
contact her?), is to send a report to the doc on what you found and what you
recommended and the educational process begins. Keep the faith.
Laurie Wheeler, IBCLC, MN, RN
Violet Louisiana, s.e. USA
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