I agree with Heather, this baby needs medical attention and not more
nonsense.  This baby was about 12 % below birthweight on day 15.  Its
birthweight in metric was nearly 4320 grams and it has lost over 500 grams.
We don't know from the information given whether the baby has been weighed
at any other point since the birth, so we don't know whether the weight on
day 15 is the lowest weight or if baby has been even more underweight
previously.  I would not expect such a baby to be suckling well. I would
want to know exactly what is meant by 'vigorous' and I'd like to feel very
certain that some qualified health care professional with expertise on
breastfeeding newborns had in fact seen the baby and examined it before
using such a word.  Like Heather, I would want a speedy referral to a
pediatrician, and it worries me that the mother claims to be seeing her
pediatrician, who supposedly has suggested 'first, a tincture of time and
midweek he suggested some water and a small amt. of prune juice for the
baby,'.
Is it plausible that a pediatrician with a current license to practice would
recommend water or PRUNE JUICE to get a two week old baby who is dangerously
far below birth weight, to stool?  This sounds so not right to me that I
would personally want to talk to the midwife who supposedly is following the
baby and I would want a release from the mother to allow me to speak
directly to the pediatrician and to her midwife.  If the mother was not
happy for me to confer with her other health care providers I would consider
bringing in Child Protective Services.  Either the mother's story is not
true, or the doctor should be reported to the state medical board as unfit
to practice.  The baby needs to be seen by someone in any case.  It may well
be a medical issue but there is also the possibility that the mother is not
being entirely truthful to the person helping her by phone and e-mail and
that it is simply underfeeding.
Goat's milk is about as inappropriate as prune juice, it has no place in the
diet of an underfed human child of this age, and only debatably as part of
the diet of much older children regardless of their nutritional status..
The mother is expressing and supplementing with 'small amounts' of her own
milk.  The baby should be getting about 150 ml of milk per kilo weight,
using its birthweight to calculate amounts until birthweight has been
surpassed, every day.  That is about 500 ml or 18 ounces, in 24 hours.  How
and by whom was the pre- and post feed weight carried out?  It just doesn't
jibe that the baby could be taking as much as 60 ml or 2 ounces at any
feeds, and still be so far below birth weight.
Everything about this case sounds off.  Good luck at sorting it out.

Rachel Myr
Kristiansand, Norway

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