Hello! I have been No Mail for a long time, but got a complicated call
today and would appreciate your insights. Mom calls with a two week old
daughter and tells me:
*Baby was born on January 10 and weighed 7lb. 4 oz. At discharge she
weighed 7lb. At nine days of age she was 6lbs. 12 oz. and today she was
6lb. 9oz. Nurses today noted that baby did not show signs of dehydration.
*Mother had breast implants surgery about 6 months before she got pregnant.
She discussed her desire to breastfeed with the surgeon and he used the
under the breast incision.
*Baby did not have a bowel movement from the time mother brought her home
until she took her to the family doctor at nine days. The doctor said baby
was constipated, that it was nothing to get upset about and recommended
giving the baby a suppository. The mother did and baby had a bowel
movement. Baby has not had one since.
*The doctor was out of town today and mom became worried and took baby to
the health department where they recommended supplementing 2 ounces after
each nursing with a starter SNS and ABM.
*Mother was having nipple soreness, but it seems to be resolving.
*Baby is nursing for about 30 minutes on each side, every two hours,
including at night, except for one 4 hour stretch. She is sleepy and hard
to wake up and falls asleep after nursing. Mom doesn't feel letdown. Baby
has 6-7 wet disposable diapers a day. Baby receives nothing else by mouth.
Birth was full term, vaginal with an epidural. Mom limits caffeine to 1
cup of coffee a day, but has started smoking 5-6 cigarettes a day since
baby was born. Mother is taking Amoxicillian for a urinary tract
infection. She can't get any milk using a Nurtura III, but can hand
express a bit.
My suggestions SO FAR: 1) feed the baby! 2) consider taking baby to
a knowledgeable pediatrician tomorrow! 3) switch nursing 4) L______h for
sore nipples 5) many women can breastfeed if there is no or limited damage
from surgery, so there is no reason to give up yet
It seems, even considering the mother's low milk supply and baby's
weight loss, that the baby should be having SOME bowel movement. Other
moms I've worked with, with much lower supplies, have reported at least
some staining, often at each feed. I am concerned about an underlying
medical problem.
Please send me your thoughts, comments, and ideas directly as I am
still No Mail.
Thank you for taking the time to read this!
Sincerely,
Elizabeth Tencza, LLL Leader
Johnston County, NC (USA)
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