Subj: Introduction; Vaters syndrome
Date: 8/14/99 6:14:36 PM Pacific Daylight Time
From: JLBENBROOK
To: [log in to unmask]
Sorry all the first time didn't work ...
Hi all from sunny southern California. I have been a "lurker" for about a
month now and I can't tell you enough what an honor and privilege it is to
have access to some of you lactation "Gods" and "Goddesses"!!! I have
learned so much!! I have been a Perinatal nurse for over 10 years and
lactation educator/consultant for almost 20 years. I am an IBCLC. I have 3
children: 19 y/o, 15 y/o, and 21 months (still breastfeeding!).
I hope I am posting this correctly, so here goes...
I have a patient who delivered 6 weeks ago at 34 weeks gestation. At that
time we knew her baby had hydronephrosis (she had had a decreased AFI for >12
weeks, we suspected a blocked urethra that had spontaneously unblocked), we
were totally unprepared for what came out...needless to say he has multiple
anomalies consistent with Vaters(imperforate anus, renal dysfunction,
possible vertebral anomaly- no tracheoesophageal atresia). He has a
colostomy, vesicostomy, minimal O2 via nasal cannula, and they started
peritoneal dialysis early because his creatinine was through the roof (it is
currently intermittent to allow all the surgical sites to heal).
There are two major issues:
#1 Mom's milk supply is low. I have instructed her on all the usual
interventions(frequent pumping, increased fluid intake,
relaxation/visualization techniques etc). I suggested fennucreek and Reglan.
The nephrologist has told ok to the fennucreek, but no to the Reglan because
of the infants renal status, and "there is just not enough info on this drug
in breastmilk". I do not have Dr. Hales current book, so maybe someone could
just privately E-mail me with the info??
#2 I hope Dr. Wight is reading this...They will not allow him to actually
breastfeed because of the need to monitor his I & O's (he is currently only
on 20 cc po feeds q 3 hrs). I suggested weighing before and after but they
nixed that! They have told her that she can pump and "empty her breasts as
much as possible" and then latch him on for a short time; that a "few extra
cc's was ok".
Needless to say with the bottles, long pacifiers (courtesy of OT) she said
he's biting - but that's another issue entirely. I suggested SNS at the
breast ---is that a viable option for this kid in this scenario???
Armed with correct info this is a mother who will do battle...I want to make
sure I am in fact giving it to her!
Thank you for your help.
Liz Benbrook, RNC, IBCLC
Orange County, California
P.S. It really helps to know what city and state you all hail from!
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