Well, it happened again.
Pediatrician referred a baby to me last week.  This 3 1/2 month old had LOST 8
ounces over the last 6 weeks.  Mother states she was shocked.  Though
everything was going so well.  Baby was content, didn't cry.  Fed normally!
No illness.

Birth weight         7 lbs 9 oz.
at 2 months was 10 lbs 9oz
at 3 1/2 months  10 lbs 1 oz

She has been nursing baby 6 and sometimes 7 times per day for 7 1/2 minutes
per breast.  (How many mothers do you know who are so percise about how long
they nurse?)  The rest of the day and night baby lives with a pacifier in his
mouth. "But sometimes he only plays with it."

Guess what?  Mother attended the Ezzo's "Prepartation for parenting"  program
taught in a local church.  She said she didn't agree with all of it.  I told
her as gently as I could that "the program" recommend feedings last 30
minutes, so her baby was really only getting 1/2 of the amount of time at the
breast as her class recommeded.  Mother was convinced she just didn't have
enough milk, even though baby HAD been up to 10 lbs. 9 oz before.

Results?  We had a terrible consult.  Baby screamed the whole 1 1/2 hours.
She had been trying to force him to take formula the previous 3 days as Dr.
had recommended and baby had terrible gas pains, arched and screamed and
screamed and screamed. Would not nurse, refused bottle, refused cup, spoon,
EVERYTHING  (except the pacifier) and just screamed and SCREAMED.  Continued
to refuse the breast.   Inconsolable, unless pacifier was used. My associate
was a nervous wreck when they left just listening to the screaming from the
next room.  I spent most of the time just sitting across from her asking what
I could do to help calm the baby.  Sent her home recommending she do whatever
worked to get him to eat, decrease pacifier use and nurse as much as possibe,
switch to a soy formula to try to ease his stomach discomfort, for any
supplement doctor ordered given other than her milk, pump 8 times a day to
increase milk supply and give all milk pumped. To return next day for weight
check.
Next day baby mother reported baby was upset because of waking in the night to
feed as doctor had told her and baby was not used to that. Feedings were poor
although baby took 3 ounces of breastmilk via bottle she had frozen before.
Baby normally slept from 8 pm to 7 am.  Baby had LOST another 1 1/2 ounce,
which I reported immediately to pediatrician, and baby was hospitalized the
day after that.  In the hospital they force fed the baby formula, which was
finally accepted after a hour of screaming at the nurses giving it.  Baby
gained 12 ounces in 2 days.  Mom is now nursing once a day and is very happy.
No other medical problems identified.  "Now I can go out and do things!" was
her enthusiastic comment to me today.  She has no desire for further lactation
help.  I have no idea if she is using the pump. She didn't want to talk
longer.

I know this mother felt terrible.   I used every technique I know to praise
her mothering,  No matter how careful I was not to blame her, the scales
proved she was inadequate.  You should have seen her fuss over dressing the
baby perfectly and fixing baby into carrier/seat, just so, with blanket,
pacifier, and stuffed animal cuddled up to the cheek.  I know this was to show
me what a caring, good mother she was.

How can things be this messed up?

I mailed the Feb 17th Wall Street Journal article to doctor along with my
report.  (Go Jan!!)

Sign me .. . . .   depressed.

Jane Bradshaw RN, BSN, IBCLC
in Lynchburg, VA