Hi Jacqui,
Simply put, here is the situation:
Either the baby is not taking in enough calories (this equates to not enough
volume, if totally breastfeeding), OR
The baby is taking in adequate volume and calories, but there is a disease
process going on that is either using extra calories (infection? heart?), or
not allowing foods to be processed properly (metabolic, genetic?).
The first situation (not enough calories) could be not enough milk
production by mother, not bf often enough, tongue tie, baby self-limiting
due to reflux or respiratory issues (?silent reflux, aspiration) and the
like.
I beleive we have talked about other families where a 6th, 7th, or 8th baby,
for example, was not breastfeeding enough, due to very busy family life, and
an active or complacent baby. You also mentioned it is a stressful time, and
the mother even said "overwhelming."
I agree with the poster who recommends looking closely at the baby's intake,
by pre/post scale weights with a scale made for this reason. Also increasing
the milk production if that is needed. If mother has good production, and I
would not think she would under these circumstances, then she could pump and
top off baby with her own milk by cup or other method. That is provided baby
would take it.
I am not sure how I feel about using solids instead of supplementing with
own milk, donor milk, or even formula, because a food like sweet potato is
not a complete food and I think baby's overall nutrition could suffer. As I
see it, baby is already at a nutritional deficit.
So I would be working on increasing the breastmilk intake, mainly.
If at all possible, I would want mother to see a different healthcare
provider, because if the interaction with this provider is as mother
described, this is not the right provider for this dyad. And precious time
could be lost.
Laurie Wheeler RN MN IBCLC
Mississippi USA

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