On March 30, I posted about what I thought was an interesting case study,
hoping some people would be interested enough to take some educated guesses
as to what was going on. Well, either it was boring, or obvious, or ???
since only about 4 or 5 responded to me privately, and there was no
discussion on the list. Maybe everyone knew the answer already, and thought
it was dumb...I'm not sure.
Anyway, for those of you who were interested, and for those of you who posted
to me privately, thanks.
Here's the case study:
<< Baby boy born on Sunday, normal vag delivery, birth weight 8#4 ounces.
Normal hospital course of events, blood sugars normal, circ, roomed in with
mom, etc etc. Baby bf "well" by all reports when he is discharged Tuesday
evening. Discharge weight 7-12. On Friday morning she calls the lactation
consultant (a friend of mine), and says the baby isn't breastfeeding well, is
sleeping a lot, and she has to wake him to feed. States he's pooping quite
well -- 3 to 4 stools a day which are beginning to turn yellow, but she
hasn't seen any wet diapers since they went home. Lactation consultant has
her come into the office. Baby is 8#2, well hydrated. She does an ac/pc
weight (don't read that part, Heather!! :>D) and he takes 22 ml. She has
mom pump, and mom gets about 75 ml with pumping. Baby is now asleep.
>>
The IBCLC in the case examined him very carefully and discovered there was a
thin, transparent membrane covering the urethra which had occurred following
the circumcision. Baby couldn't pee. He was immediately sent over to the
pediatrician who probed it. Baby voided 120 ml immediately, and then nursed
voraciously. Apparently he was in so much pain that he simply shut down, and
would only bf enough to keep hydrated. He also lost 4 ounces immediately.
This happened to us once in the Family Birthing Center -- at that time, we
had a policy that babies had to void at least once before going home after
they were circ'd. One particular baby didn't go and didn't go -- parents
were dressed, ready to get out of there, and punkin' still hadn't peed. We
did every trick known -- warm water over the penis & scrotum; tickled his
back, put him naked on a nice bedspread, pressed on his bladder. Finally, at
about 12 hours we looked VERY carefully -- and sure enough, there was this
very thin membrane covering the urethra. Called the peds who got a urologist
over there who probed it, and all went home.
Jan B in sunny Wheaton.
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