Hi All,

I'd love some collective wisdom.  I saw a family tonight for poor weight
gain.  What thoughts do you all have for why the baby stalled
gaining weight between week 3 and 5?

birth wt        6,7
discharge       6,1
3 weeks         7,1
5 weeks (10/29)         7,3

neither mom nor babe on any meds, incl. hormonal bc
mom reported pain and some scabbing early on that resolved
has had one bout of mastitis (rt breast) & 3 plugs, various locations
smallish nipples protruded, very slightly compressed after nursing
no visible damage or scarring
baby has been examined by ped and appears very alert and active
tongue somewhat heart-shaped but protrudes well over gums while nursing
baby latches well with nicely flanged lips
digital suck assessment revealed nothing remarkable
baby nursed throughout my one and a half hour visit, fell asleep at
breast quickly, responded to waking techniques, breast compressions and
switching sides
ped ordered supplements after alternate nursings
mom refused consult until today and only pumped 1 - 2 times daily with
avent Isis, yielding about 2 ounces total
mom had multiple let downs, baby responded with deep jaw excursion
swallowed with every suck when awake and alert

Offered mom options:
supplement with SNS at breast
use good pump 5 minutes post feed
switch sides and use breast compressions frequently

Mom opted for Lactina and plans to pump 1 or 2 times daily, also plans
to switch as soon as baby slows down and use breat compressions


--
Kym Smythe, MEd, IBCLC
Bear, DE, USA

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