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From:
laurie wheeler <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 12 Jul 2003 17:59:51 +0000
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Hi Norma,

Congratulations to all on the beautiful grandbaby and very good *bucking*
the hospital system and keeping mom and baby together and breastfeeding!

Your report of the circumstances brings up alot of red flags, unfortunately.
You said (and I am capitalizing the worrisome phrases):

<<In the morning her milk was definately *in*  - but that was when the
trouble started. Since then, the baby will go willingly and eagerly to
breast, latch beautifully, NURSE VIGOROUSLY FOR A FEW MINUTES AND THEN
FLUTTER SUCK. Between times he is either sleeping and quietly alert. We have
NOT SEEN ANY POOPY DIAPERS since then. He is getting 4-5 very wet ones every
24 hours. Eliz has been doing breast compression and switching sides
whenever her slows down. Yesterday I rented a Medela Lactina. She PUMPED 2
OZ IN 10 MINUTES AFTER HE NURSED>>

Here are my concerns: 8#14 to 8#0 was right at a 10% weight loss, first red
flag. What about jaundice, and how *soaked* were/are the diapers? A big
question to me is this: HOW WERE THE WEIGHTS DONE? Was the baby in ANY
CLOTHES OR DIAPERS at any of the weight checks? If so, the weights are
inaccurate. Yesterday I showed some parents that the clothes they had on the
baby weighed 10 oz! And this is in July in New Orleans! So that is the first
thing to check right away. If in fact, the baby is gaining, about an oz per
day, then I think it would be highly unusual not to have poops and some
other ?GI problem should be investigated. This would be my opinion.

I think definitely the mother should continue her regular milk expression
and feeding this to the infant. He may very well be gaining on the ebm supps
but the problem seems he can't elicit an MER/extract the milk. Are the
nipples very large? A before and after bf weight would give some good info,
so perhaps renting a scale? Then weights on the same scale could be done.
Let us know how it turns out. Certainly she has great skilled help and
support, so they should do just fine.
Laurie


Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA

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