I have a friend whose mom delivered her 3rd child (a girl) who has given
me permission to share this: (I don't really know the bf history of the
other 2, but they were about 19 and 23 years ago or so) monday. We went
by to see the mom this evening and I was rather concerned about some
things. I will lay out what I know, and let you wise ones tell me if I
really should panic. ;-)
-This mom had a miscarriage around about 11 weeks along, maybe a year
ago or so. These pregnancies recently were after having a tubal
ligation reversed.
-Baby was born after about 9 hrs of labour, augmented, but I don't
BELIEVE the mom had an epidural (not sure).
-Don't know APGAR's.
-Weighed in at 7 lbs 12 oz.
-Had jaundice severe enough for lights/blanket (don't know how much
jaundice as blood volume measure), due to a blood incompatibility that
was not seen during the amniocentecis (sp?) that the mom had, given her
age (45 I think).
-This morning was her last morning under the blanket. The mom said she
(baby) was very hot when she pulled the blankets off her each time, so
I'm assuming this might have made her lose a lot of liquid.
-Baby has lost 12 oz which I calculate to be around about that "magic"
10%.
-Baby has not got visible outward signs of dehydration such as sunken
fontanelle/eyes, dry lips etc.
-Baby seems to be nursing well. Mom thinks the suction is good and
nursing doesn't hurt. Lips are flanged out as they should be. I did
tell mom to check with a finger to make sure tongue was DOWN not up
against palate (though I suspect she'd feel that if it were?).
-Mom is looking somewhat at a clock. I made comments about babies not
being able to tell time, and wouldn't be able to for several years yet,
and that CRYING is one of the last signs of hunger for a baby, not a
first one. She said she had let her cry a bit this morning before
nursing her. I mentioned also how crying would make her lose humidity
from her lungs and perspire perhaps. Maybe enough to eliminate one baby
urine?
-Baby does not like a pacifier (gags) but does suck on her thumb. I
said the not accepting a paci. was a good thing especially for now, but
that if she saw her sucking her thumb she should nurse her.
-In hospital baby was in incubator the first day or 2 at night, crying.
Also got a few feeds of formula by cup because they said she was not
getting enough liquid with just colostrum what with being under the bili
lights. (??? is this true??? Somehow I doubt it if she was let nurse on
request!). Most of the time it was about 10 cc's each time, but one
nurse actually gave her a bottle of 50 cc's (which I gather the mom
chewed the nurse out for doing, yay mom!). Nurses gave conflicting
advice, so the mom followed what seemed logical to her (and to be
honest, I didn't ask what that was).
-Baby is just over 4 days old, mom's milk is in (not sure which
day...probably day 2 or 3), and she's still pooping meconium.
-Mom thinks baby is not urinating more than one to two times per day.
These 2 things make me worry a lot. I told mom to nurse the baby LOTS,
to undress the baby so as to wake her up more, to do some skin-to-skin,
and to put an old face cloth (or other rag of some sort) in the baby's
diaper (disposable diaper) to make sure she caught all the urine (i.e.
to make sure she knew when it happened). These disposables can conceal
urine easily. I also told her to take one of the disposable diapers and
empty a couple of tablespoons of water into it to see how heavy it'd get
with a small baby's pee (average).
I said I wanted to hear if her stools were getting paler tomorrow and if
she'd had a GOOD 6 wet diapers (or face cloths as the case might be) by
tomorrow. I have an IBCLC friend I could call, but it is late at night
now and I thought I would wait until tomorrow to do that, at a
reasonable time of day.
What else should be said, looked at? I said all I could think of, and
this was by no means a "professional visit" as I know I am not a
qualified IBCLC and this was just drop in on a friend and her mom to
congratulate on the new baby and give her a few tips if she had sore
breasts or something. I didn't actually expect to find them having so
little urine (I am **really** hoping hard it was just that those
disposable diapers soak up so much that you can't tell properly!) and
still having meconium. I will not hesitate to call in "the big guns"
tomorrow if there is no improvement, but at what sign of improvement
should I *not* do it? If there is no improvement, I will call my IBCLC
friend. But if the poop starts turning more pale and she has 6 wet
diapers, is that improvement enough to let it go another day (and
assessing again then) or should I still call my IBCLC friend? What if
she's up to 10 wet diapers, and has seedy yellow poop by tomorrow
afternoon? Is that good and safe by then?
Thanks so much in advance, maybe I,m just a worry-wart and maybe it's
just that I'm anxious to make sure that she gets it all right, but the
supposed absence of urine and seedy yellow mustard stools has me
worried.
Fio.
ressource person for Allaitement Québec
Mama to Sandrine Leïlou, 13/03/00, still nursing.
***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html
|
