Babe seen at 11 days.  Wt loss 9%.  Mom states that she is nursing all
the time.  Denies bottles, pacifiers.  Babe looks healthy; pink, good
skin turgor, moist membranes.  Latches easily, @ 1st exhibits good
open-pause-close type sucks/audible swallowing then goes to sleep.
Never "falls off" the breast, never seems satisfied.  Test weight
increased 24 gms after fifty minutes at the breast.  Nipple is slightly
misshapen after nursing.  Side-view is slanted toward the top of the
nipple.  Babe cups tongue around nipple during nursing.  Mom declined a
rental pump.  She left with instructions to finish 1st breast, br.
compression, supplement at breast, wt ck tomorrow (I question her
return).  Is this just a normal babe on the way back to B.W.?  Am I
missing something?

Royce Anderson, RN, IBCLC in Oklahoma City where it's too warm for
December

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