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Date: | Mon, 6 Mar 2006 20:18:25 -0600 |
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It is very good you did test weights on this baby because that leads you
to know what is wrong. On day nine when baby only took in about 18 ml at
the breast, supplementation at every nursing session should have started
-- in my opinion. A baby this age should be taking in at least 2 ounces
per breastfeeding, some feedings should be 3 ounces. If this was a
c-section birth, or an induction with a long epidural baby may have been
too groggy to learn to suck actively. Sounds like baby is just getting
the initial MER, second side with just barely any intake indicates no
MER happening. Weak babies can not suck well.
I often put these large weight loss babies on the bottle for two days
with strict requirements to feed enough per 24 hours and have the mom
use a rental pump to stimulate her milk supply 8 times in 24 hours.
Enough calories would be birth weight times 2.5 ounces in 24 hours and
maybe bumping it up some. I would have suggested 7 lbs. times 2.5 ounces
or 18-20 ounces each 24 hours. After two days of intense feeding like
this, baby would have been stronger and more vigorous and then test
weights would have shown you what he could do.
Right now, I would have her feed this baby by any method she chooses as
long as baby is taking 2.5 ounces per nursing session or bottle feeding
and 8 times in 24 hours. Human milk is of course best but at this point
the most important thing is to feed the baby. Supplementation at the
breast is good but if baby will not participate in feedings due to being
weak from losing weight and not having enough caloric intake, mom will
have to use bottles to get him to increase his intake. She will have a
stronger baby in 48 hours. I find most mothers dislike the SNS and won't
use it after I leave their house.
Again, she can use 2 ounces of supplement at each nursing session by
eyedropper if she wants. She could get a periodontal syringe from her
dentist (10 ml each, or 3 syringes -- 30 ml -- per breast). She will
have to be aggressive and measure this out in a cup before starting.
Supplementation at the breast can teach a baby to suck vigorously but
sometimes this doesn't work if baby is too weak and is not participating
in feedings and shuts down quickly. If mom wants to feed 10 times in 24
hours, that is fine, adjust the supplementation down a bit. Most moms
are too overwhelmed to nurse with supplementation, then pump, and then
do it all again every 2 hours and choose to try to get more down the
baby less often.
Mom needs to be on a pumping regiment to stimulate her milk supply.
Pumping after every nursing or bottle feeding or 8 times in 24 hours.
Best to this baby, hope it works out.
Kathy Eng, BSW, IBCLC
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