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Date: | Sat, 6 May 2006 01:23:15 +0000 |
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Hi Jen
Thanks for the update on the case. I would be inclined to recommend
continued use of reglan because it may take some time to get the thyroid
situation under control. Repeat lab testing will likely be necessary until
the situation stabilizes. More importantly, though, seems to be the fact
that the baby is transferring very littlle milk. So mother should continue
expressing with a hospital grade pump.
I would also refer this mother to a primary hcp or endocrine doc for
continued follow-up.
This mother is at risk for continued low milk production due to early
factors, confusing weights, etc, as early milk volumes seem to predict later
volumes. I would clue her in to avoid as many factors as possible that tend
to decrease supply such as birth control hormones, certain medications,
scheduled feeds, long interfeed intervals, baby sleeping all nite etc.
<<<The most milk she has measured at one time was 68 grams but there are
still nursings where just 6-8 grams of milk are transferred...>>>
<<< should the mom continue on the usually course of Reglan?>>>
<<<went to urgent care.....should she find a specialist or GP to for follow
up? >>>
Laurie Wheeler, IBCLC, MN, RN
Mississippi, s.e. USA
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