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Date: | Fri, 18 Feb 2005 16:12:48 -0500 |
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Remember that poops (stools, bowel movements) are a much better
indicator of sufficient breastmilk intake in the early weeks than wet
diapers are. We want infants to have 3-8 dirty diapers each 24 hours
between when lactogenesis II happens and about 6 weeks of age. Starving
babies can have enough wet diapers, as has been seen in some of the
tragedies that were well publicized by the Wall Street Journal several
years ago.
Once the gastrocolic reflex subsides (after 6 weeks) the baby no longer
stools as often, and we don't worry if they slow down.
I agree that this infant should be fed in any manner that is efficient,
and carefully examined for cardiac, respiratory, or oral anatomical
issues that might have led to the failure to gain weight. Mom should be
assessed for hypothyroidism, retained placenta, hormonal imbalances,
breast hypoplasia, and mismanagement of breastfeeding. The fact that
her other babies were slow gainers increases the index of suspicion that
there is a maternal factor, or an infant genetic factor such as tongue
tie. The doctor will have much more respect for lactation consultants
if he/she sees that we care about the baby's welfare first and foremost,
and are reasonable- knowing when getting food takes priority over
breastfeeding.
Catherine Watson Genna, IBCLC NYC
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