I just heard a doozie. Went out to see a couple with a term newborn,
diagnosed with a VSD, which was why i was seeing him. Mom went home
breast and bottle feeding, her goal is exclusive breast. The history she
related gave me goose bumps and got me hopping mad. Seems she had a C?S
after a prolonged period of unsuccessful pushing. Baby sent to breast by
6 hrs of age. Mom reported that he nursed for 20 min on a side and was
irritable and "hungry all the time". she had large painful blisters
within 24 hrs. But...since he was nursing frequently for 20 min a side,
he was labeled a good feeder. On day 1.5 she was worried, pointed out
repetitive jerky movements, a dry mouth, wasted appearance, and
inconsolable irritability. Nurses told her breast feeding was supposed
to hurt for the first couple weeks, all newborns have jerky movements and
then blew off the dry wasted appearance. They told granma to stop
looking at him and then you won't see the jerky movements. From what she
described to me, this sounds a lot like dehydration, hypoglycemia and a
horrible, ineffective latch from the onset. She demonstrated the jerky
movements and they might have been seizures as a result of the issues
described. She kept him in the room as she was worried about him and
was blown off so often, he was taken out to be weighed on day 2 and had
lost 16 oz from birth weight. At that point he was labeled as sick, a
murmur was found, he was given a bit of glucose water and transferred to
a tertiary care center, but the nurse told them he had a life threatening
heart condition and will probably not live. He was hydrated at the new
hosp, her breast feeding was reestablished, and he was placed on Lasix
for the VSD. I found distraught parents, reliving every horrible moment
as if it was yesterday. I got him nursing and content at breast,and gave
her ways to increase her milk supply. They were thrilled for someone to
tell them to go to bed with their baby. m Physically he looks great, but
is one of those wiry, hi energy kids who is starving before he wakes up.
No signs of tiring during nursing, no signs of CHF. Their HMO is being
great, will give me as many visits as I feel they need. Now. .. I want
to call the nurse manager of the postpartum unit and relay this history
to her. I am not sure if I should be the one to do this, or should I
encourage the parents to do this. But...someone at that hospital needs
to know how potentially dangerous this situation was, just because a baby
was labeled a good feeder. I spent 2 hours with them, wiping tears,
holding their hand, trying to get them a little less afraid of this
beautiful little guy. I plan a phone call tomorrow, and a visit next
week, sooner if necessary. Thanks for the ranting and raving space.
Ann McAdoo RN
Simsbury CT USA
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