"The mother states she is certain
her regular ped will listen to her and she is planning on taking the baby to
him tomorrow.  I guess I can't see any point in going to the ER again.  But
I'm still worried..."

By my calculations this baby is at almost 20% wt. loss.I would talk to the
pedi on call for  this weekend and let him/her know about the alarming wt. loss
and the  behavior you see in this baby. If the baby had a "clean bill of
health" why did they give  IV fluids in the ER? There must have been clinical signs
of dehydration. What were the electrolytes?  This is such a frustrating and
scary situation for you and the family over the weekend. The best you can do is
call the pediatrician and clearly state that you are very concerned about
this baby and that wt. loss is at a dangerous level. Meanwhile parents are
probably getting enough fluid into the baby to keep him from further dehydrating,
but something is wrong. My guess is that when mother became engorged,
breastfeeding became difficult for the baby, he lost wt., became dehydrated which leads
to lethargy and feeding further deteriorated. Couple this with poor advice
from the pediatrician and it's a disaster waiting to happen. I assume they did a
sepsis workup in the ER and that it was negative.

I'm guessing mom's milk supply has taken a nose dive at this point. First
baby needs to be taken care of and then mom will need to rebuild supply.

Is the ER one that has skilled personnel used to caring for infants? It's
possible this baby was not even seen by a pediatrician in the ER.

I'm sure this family is very grateful for your support at this time and that
it will be invaluable in rescuing the breastfeeding relationship.

Kathy Boggs, RN, IBCLC

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