I have a case that is very troublesome to me and the poor mother and I would
love any feedback anyone could give me.

Mom is a 39 y/o primip with vaginal birth at term. Birth wt 6-14, D/C wt 6-7,
day 7 wt 6-0 ( 12% loss), by 3 weeks wt 6-9, 4 weeks wt 7-1, then 2 days
later 7-0.
Mom has had a good milk supply, uses an electric pump between some feedings,
getting 2 oz. At one visit baby consumed an oz. with a pre and post wt check.

For the first 2 weeks was dealing with a sleepy baby and mom not using the
fdg cues and more the clock, then got this baby up to > 10 fdgs/day but they
are long
> 40-60 min. suck/swallow ratio 5:1 even with massage.
Baby for the past 2 weeks has had very good urinary outputs and > 6 good size
yellow seedy stools/day.
Her skin tugor is good but she looks thin, but some filling in her cheeks.
 Mom has been plagued with sore nipples, yeast infections, and a mastitis.
 The mastitis is resolved and the yeast seems to be clearing but her nipples
are still sore.  When the baby comes off the beast the nipples are creased
and white along this crease, they take several min before they start to come
back to their normal shape.  Also there was a question last Fri of the baby
spitting up blood, Pedi felt it was from mom's nipple but did run some blood
tests because there was sm amt bl in her urine.  All test were normal except
liver functions.  I talked to Pedi today re my concerns and she plans to work
baby up for UTI but will also take another listen to her heart.
I know this is very complicated but any ideas would be appreciated to make
sure I'm not doing something I should.
Thanks,
Ann Perry RN IBCLC