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From:
laurie wheeler <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 26 Jun 2007 22:50:24 -0500
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Hi Angie,
Interesting case. I am not sure why the baby initially was thought to have a
problem. These are my calculations. If baby weighed 6#4 at birth and had
gained 5 oz per week for 10 weeks (you said baby was 2.5 months old), baby
would weigh 9 pounds 6 ounces. You said the baby weighed 9 pounds 2 oz, so I
don't see that as a really big problem; I certainly don't see it as failure
to thrive. So there must have been some other info in there, like baby
gained very well at first and then just stalled. It seems mother has a good
supply if she can pump 6 ounces every 2-3 hours; if this is true she can
produce 48 to 72 oz of milk a day, which is quite alot!
Obviously, the baby is now having problems, in that baby is now LOSING
weight. So again the LC has to be a detective. Was the baby doing any/alot
of vomiting before being removed from bf and put on formulas? Could this
actually be an oversupply situation with baby self-limiting due to
discomfort during and after feeding? Could mom try one breast per feed for a
4 hr interval, for example, and feed frequently, like 12+ times per day? I
definitely would not recommend any tests on mother's milk, as we recently
discussed this is not at issue. Volume is the key to baby's gaining, and if
baby is feeding ineffectively, infrequently, or is self-limiting, then this
is a problem, of course. If baby has a medical problem like a heart defect,
a metabolic problem, or such, then baby could be consuming adequate
volume/calories but just not processing them or using them up too fast. I
would think that other signs and symptoms would have been mentioned if that
was the case, like fatique, shortness of breath, or not meeting milestones.
So I think you have to go back and tease it all out. Good luck.
Laurie Wheeler, RN, MN, IBCLC
MISSISSIPPI USA

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