I am posting with permission about a baby I saw in clinic this morning.
Maybe it's just my "Monday morning fuzzy headedness" but I can't quite tell
what the problem is with her.  Baby was born February 3, and is mom's 5th
baby.   The pediatric provider suggested I see this baby as "she has
slipped from the 75th to the 25th percentile  in weight".  Birth weight was
8lb 10oz and now at 7 weeks she is 9lb 12.9oz  --baby has not lost weight
but the provider is concerned about slow weight gain and mom is feeling
very frustrated.  Of note to me right away is that the provider stated that
the baby is completely intolerant to any supplement --formula or mother's
expressed milk, she will not take supplement by cup, bottle, or syringe.
The few times they have been able to cup feed this baby she spit it right
back up.  This baby appears 'healthy' hydrated and 'happy' alert but not
fussy and mom notes that she is 'very laid back'.  Mom reports that all her
babies have been 'lip tied' but that with this baby soreness improved much
faster. She denies nipple soreness or pain while nursing at this time.  I
observed baby's latch and she latches well but comes on and off the breast
multiple times during a feeding before she falls asleep. I wondered about
supply (low or over supply) but neither appears to be the case.  Mom states
that while she had a period of 'nursing all the time' she nurses every 2-3
hours during the day and would probably go all night but mom wakes her to
feed in light of slow weight gain. Diaper count could be better, 4-5 wet
diapers a day and 1 stool a day--which ranges from yellow to green.
I see mild lip tie and no tongue tie, but this baby will NOT suck on a
gloved finger or ANYTHING except mom's breast and a 6 month + size 'mam'
pacifier which the baby only has because one of her older siblings found it
in an old diaper bag and popped it in her mouth one day. There is no
apparent oral issue here and no reason for low tone but that is the only
explanation I can think of.  THOUGHTS ANYONE?
your input is appreciated!!

Molly Scarborough McMillion RN, BSN, IBCLC, CCE, CPST
Lactation Consultant, Childbirth Educator
Special Projects Consultant - West Virginia Perinatal Partnership
Right from the Start - Direct Care Coordinator
304.667.4362   www.babylovegbv.com

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