Dear Laurie,

I agree, there is cause for concern.  There are multiple factors here.  
The baby is being supplemented with the mother's EBM, by the way. So you 
are right, the baby is not feeding effectively at the breast.  The dyad 
is being seen by a doctor and a public health lactation specialist in a 
nearby town.
The mother called me with those two questions however, can Domperidone 
slow a baby's bowels and can bilirubin be reabsorbed from breastmilk stool?
Thank you for your answers, I will pass them on.

Eva

Eva Bild, MA, CD (DONA)
Certified Doula, Childbirth Educator, Breastfeeding Counsellor
Mothering Touch Centre
1562 Fort Street 
Victoria, BC
250-595-4905
www.motheringtouch.ca



laurie wheeler wrote:
> I would be very concerned about this dyad. First, if baby is being 
> supplemented with 2 oz x6 each day, that is a large portion of his 
> intake. Is this the mother's own ebm or a donor's ebm? If it is the 
> mother's, then obviously baby is not breastfeeding effectively and 
> needs evaluation and assistance.
> If this is donor milk, then mother again is having low supply and 
> needs evaluation and further help.
> I do not think the domperidone is slowing down the baby's bowels.
> While it may be that the rare baby is gaining weight very well with 
> only one large yellow b.m. per day, it would be far from typical and 
> merits evaluation (in person).
> I do not know the exact proportions of bilirubin in meconium vs 
> breastmilk stools. I do believe the meconium has a large amount and 
> that later stools have less. But my understanding
> is that the baby could still be reabsorbing some bili from the stools. 
> If baby had a traumatic birth, as you say, perhaps there was alot of 
> bruising, cephalhematoma, or similar which would add to the bilirubin 
> load.
> Any time a mother is concerned and when there are the above red flags, 
> this would warrant a thorough in-person evaluation of the dyad.
> Let us know how it goes.
> Laurie Wheeler RN MN IBCLC
> Mississippi, s.e. Usa

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome