>Hi Heather,
>
>Thanks for your feedback. At the point at which the mom called me and I
>observed the feed I was worried about the baby's listlessness, the further
>wt. loss, crystals in the urine and no poops. I did recommend supplementing
>with mom's own milk based on what I saw. As the baby further progressed,he
>was more active, less needed to be coaxed into nursing so at that point I
>did recommend more on demand feeding, especially when after a week or so
>when poops became more plentiful. Now my thoughts are why did the baby lose
>wt. in the last week and could it have to do with the spitting up and I
>wondered if it could be overactive letdown in spite of baby not having
>reached birth weight? Now the ped wants her to step up the supplementing
>again. I do wonder about the possibility of over intervening having an
>effect on whats going on. Any more thoughts? Thanks again.



Well, I dunno.....I'd want to know exactly what the mother means by 
the baby "spitting up massive amounts in the
morning several mornings in a row after sleeping for a few hours and she
kept putting the baby back on and the baby did this three times one morning."

  All of that could just be the baby spitting up - babies do this. 
Maybe the baby is getting too much, and brings it back up again - 
normal.

Mothers will say it's 'massive amounts' when a more experienced 
mother (or bf supporter of whatever hue) will recognise it as no more 
than a 'generous' amount rather than a sign of some pathology. 
Pyloric stenosis is characterised by projectile vomiting, and if it 
was projectile, the mother would be able to describe it in a way that 
made it clear this was not just spitting up.

If these spittings up are within normal limits, I would share your 
concern that the over-intervention here has obscured whatever might 
or might not be going on. Is it perhaps possible for the baby to 
return to normal, physiological, ad lib, non-restricted feeding 
(having attachment and milk transfer checked to make sure it is good) 
with plenty of physical contact day and night...and just see what 
happens? If everyone is twitchy about weight, then she could continue 
to supplement with EBM if she felt it was necessary.

(I'd also retain a bit of scepticism about how accurate these 
weighings are, given you didn't actually do them. The baby is well, 
yes?)

Heather Welford Neil
NCT bfc, tutor, UK




-- 
http://www.heatherwelford.co.uk

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