Hi all--

I can relate to the recent posts about slow gaining babies and remind everyone
that we have to empower moms to find more supportive doctors/nurse
practitioners.

I have a client who was put on Cipro for a kidney infection and willing to
pump for two weeks. (I did review with her the info on Cipro and the diverse
points of view regarding its use with bf--she opted to pump; it is her second
baby and she had no concerns about bf not working when it was resumed).

Meanwhile, mom pumped 3 oz about 8 times per day on most days; the baby (8
weeks), who had been doing well with exclusive nursing, would only take 2 oz
of formula and that was a fight. By the time the mom finished the drug regime,
baby latched on readily (it was deprived, and hungry!!).

Mom took baby to Pediatrician, who dx baby as failure to thrive because it had
not gained any weight during the last few weeks. Looking at the whole picture,
and mom's gut feelings, baby had stayed at the same weight for the three
weeks, but grew a couple of inches; head circum ok; developmentally, doing all
of the things he should; bright, alert, active, smiling and cooing; good wets
and stools; good skin turgor--just because he didn't match those stupid growth
charts the doc was concerned and insisting on supplementing with--you guessed
it--formula.

I worked with the mom to bargain for more time; met with her and assessed the
feeding--you could hear swallows from across the room!! and we knew what her
volume had been from pumping.....well, to shorten this post, baby GAINED 2 oz,
then 9 OZ, then 4 OZ over the next few weeks. The doc was still concerned and
insisted that baby needed to be supplemented with formula (I had already
spoken to mom about supplementing with EBM if it became necessary; also
strategies to increase fat intake of bm).

This time mom called for referral to a more supportive doc, as she feels the
baby's whole problem began with the formula for two weeks.  I gave her several
names (which I don't do on a routine basis as I work in the hospital) with
strong recommendations. She got her second opinion, which was that the baby
was doing fine, esp considering the "insult" he had been through!!

PS--mom has a new pediatrician!!

Good luck with the recent case on poor weight gain. It can be a tough
situation, but keep in mind that formula usually isn't best!!

Kathy Rubin IBCLC RNC in NJ (just finished a paper on fathers and
breastfeeding--very enlightening!!)