I am in need of input I have permission to post:  some of this post is
copied from the mother's e-mail to me...

 

History ; 6th baby ( oldest child is 11 years old), NSVD GA 41, 8 lbs,
9oz.  Spent 4 days in NICU due to high heart rate, then sent home with
the "all clear".  BF all children till age 2.5, very educated about
birth and breastfeeding.

 

 Post from mom: "BabyKyra is almost 7 months old (the 13th) and weighs
12 lb 9 oz.  The electrophysiologist and cardiologist both now agree
that her heart is not the cause of the slow weight gain - it is
functioning normally with the pacemaker and we don't need to see them
again for 3 months.  Her length puts her in the 50th percentile (down
from 68th 2 months ago).  She appears to be making all the developmental
milestones; we go for a developmental assessment on the 18th. All the
blood and urine tests ordered by the GI dr at Nemours came back normal.
The gastric emptying scan also showed normal function with no reflux.
The sweat chloride test has to be repeated a 3rd time as she didn't
sweat enough to do the test.  

 

I am currently pumping and fortifying with powdered formula to achieve
24 calorie per oz.  Today I started her on a schedule of every 3 hours,
hoping she might take more at a feeding if she has to wait a bit; twice
I fed her at 2 1/2 hrs because she was fussing.  She nurses only at her
early morning (4-5am) feeding.  She would nurse more, but she quickly
converts to a non-nutritive suck, then I have to pump after anyway to
get the extra milk out, and this whole process takes long enough as it
is.  During the day, she will not take more than 2.5 oz per feeding.  At
night (11pm) when I wake her for a feeding she takes between 3 and 4 oz.


 

Today, using the schedule, was the first time she hasn't fought any of
her feedings.  Usually, she refuses at least one or two feedings a day.
Typically, it looks like this -

 Nurse, then attempt to supplement immediately after coming off the
breast.  Might take 1/2 oz, usually refuses.  Pump out 1.5 to 3 oz.

 

Or, bottlefeed and she takes 1 oz then balks.  Wait 15 min and try
again.  If she refuses, try again in 30 minutes, etc til I'm ready to
scream.  The content doesn't seem to matter - she takes and refuses
expressed breastmilk, fortified breastmilk and formula equally.  The
bottle doesn't seem to be the problem, it's the feeding she doesn't
want.  (last week a friend watched her for me and although I left a
bottle, she asked if she could nurse Kyra.  I didn't mind; here's what
happened - she refused the bottle so my friend nursed her and she calmed
right down - til my friend's milk let down.  Then she pulled off and
screamed.)

 

She nurses easily, but when she's done, I can't make her nurse longer,
and more frequently just means more comfort sucking rather than
milk-transferring.  My supply has been affected by all this, of course,
but near constant pumping is keeping things going, for now.      As
crazy as all this is making me, she is such as joy and delight.  Kyra is
a happy little person as long as nobody is trying to feed her when she
doesn't want to eat.  Anyway, I just wanted to update you and if you
have any clues to help us solve this mystery, I'm all ears."  

 

Any, any insight or thoughts would be grateful.  FYI - this mom called
me after the heart surgery and had decided, with help from cardiologist
and gastro doctors to STOP human milk and give formula.  I was able to
encourage and validate the VALUE of breastmilk, she had become
overwhelmed and wanted to help her daughter.  Early test weights (2 & 4
months) showed 3oz transfers per feeding.

 

 

 

Kathy Bradley, ICCE, IBCLC

Maternal Education Coordinator - MP 56 

(O) 321-841-6685

(C) 321-213-1112

 

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