How long has weight %ile been decreasing? Only recently or gradually all
along? No new meds or BC on mom’s part?
One thing I’ve encountered before and heard speakers touch on is scales -
is baby being weighed WITH diapers? Is is a different scale at each visit?
I know it’s probably not the issue, but it’s at least worth knowing, I
think!
Keep us posted please! These cases always puzzle me as well!
On Thu, Aug 15, 2019 at 8:14 PM Laura Monin <[log in to unmask]> wrote:
> Has baby found his thumb?
> If mom is up to monitoring thumb sucking, and willing to offer the breast
> for some extra sucking, this will increase weight gain slightly.
>
> I’m assuming that mom is not pushing a pacifier?
>
> Laura Monin
> Retired IBCLC
>
>
> Sent from my iPhone
>
> > On Aug 15, 2019, at 5:01 PM, Lj Berkeley <[log in to unmask]> wrote:
> >
> > Hello Smart Women!
> > I am in need of brainstorming help. What follows is a "case study" of a
> > client that I have been struggling to help. I'll post in bullet point
> > style so its easy to read. What I want to know is if anything jumps out
> at
> > you (i.e. what am I missing?). He has dropped from the 50th percentile
> to
> > the 12th and mom is very upset. Pediatrician is not.
> >
> > DOB 5/10/19 boy at 39 5/7 wks, vaginal birth (NSVD) in a hospital to an
> MD
> >
> > BW 7lbs 9oz
> >
> > Wt at 2d 7lbs 2oz
> >
> > Wt at 2 mo 11 lbs 3oz
> >
> > Wt at 3mo 12lbs 3oz
> >
> > Wt at 3mo + 1 wk 12 lbs 7oz
> >
> >
> > Other pertinent facts:
> >
> >
> > Exclusively breastfed baby. Mother used shields until 8 weeks. Feeds
> > directly now.
> >
> > Baby feeds 10 x day
> >
> > Baby feeds 20 mins and generally both sides
> >
> > Baby had frenotomy in hospital at 1day of age (only tongue, not lip,
> > scissors not laser)
> >
> > Baby had small amount of GERD causing frequent spit up which has resolved
> >
> >
> > Stools: had frequent up to 2 mo and now has “massive” stools 1x day and
> > smaller 1x day
> >
> > Urine: very frequently urinates, diapers “always” wet and it appears
> clear
> >
> >
> > Baby developed eczema at 2 mo, began on his cheeks, spread to his
> > face. Pediatrician
> > prescribed hydrocortisone “oil” and mother states its helping.
> >
> >
> > Baby does not sleep with parents, but in a nearby bassinet. Feeds q
> 2-3hr
> > at night with one interval of 5 hours (usually) between 8pm and 1am.
> >
> >
> > Sibling: Breastfed +- 2 years with great weight gain all along. Sibling
> > also started feeding with shield and dropped it on her own at 6 weeks.
> >
> >
> > Mother's nipples appear undamaged, she denies any pain, feels full if
> baby
> > waits more than 2.5 hours without feeding. Her breasts appear normal to
> > me, medium sized, mildly flat nipples but evert nicely when baby attaches
> > (and round on detach)
> >
> >
> > THOUGHTS!?!?
> >
> > Libby in El Paso
> >
> >
> >
> > Lizabeth J. Berkeley, MPH, IBCLC, RLC
> > Breastfeeding Garden at El Jardin
> > 901 Arizona, 10:30-1 every Friday
> > 915-257-8844
> >
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