Hi Judy,
My comments in BOLD.
Kathleen
_____________
New mom 31 years old, with 8 day old baby, firsttime, preeclampsia, at 35
weeks, emergency CSection ( also remarkable history for little ( Dad's
statement) or no ( Mom) breast changes), when looking at the breasts and
palpating it just feels like there is nothing going on there, baby is 4
pounds, mom started at day 7 with hospitalgrade pump every 2 to 2.5 hours or
so, fairly consistently for the past 24 hours ( she just can't take much
more, she is highly delicate and very distraught from lack of seeing
anything) and when she pumps, ( while I was there and we were chatting, the
first time) she got one drop after 10 minutes of double pumping.
I"D LOOK AT THE LATCH, and fix that fast. Wondering why she has not pumped
before now, other than the fact that she is an emotional wreck after what
she has gone through?
Total output
for last 24 hours was about 7 Ccs, (which she spilled on the table).
DOES SHE HAVE RETAINED PLACENTA, or thyroid problems, or perhaps did she
bleed a LOT, ...and what are the shape of her breasts? Did she leak when
pregnant? Does she eat and drink and sleep now?
Baby is
Fingerfeeding poorly, taking about 30 minutes to take in only a portion of a
feeding. Dad and mom say that baby was forcefed in the hospital, and when
left to her own devices seems to prefer VERY slow feeds with FF even with
body or lower ( panics when it's held in the hand and clamps shut).
HOW IS SHE being fingerfed? If they forcefed her, this is NOT GOING TO HELP,
obviously. Also, perhaps this is a baby who is exhibiting classic signs of
having other problems such as internal/not noticeable respiratory
concerns/issues, and the slow feeding is her way of protecting her airway?
Bottlefeeding she takes in about 50ccs every 3 hours, which is about what was
given in the hospital but seems like a lot for a 4 pounder, no?
A 4 lb baby needs about 2.5-3 ounces of milk per lb of body weight per day,
right? to grow? I cannot recall where I got this figure either..but this is
what sticks in my memory. So, 3 ounces x 4 lb = 12 ounces/24 hours/8
feedings....= 45 cc/feeding.
Are the
numbers with a lowerweight babe different? Mom is very scared of the baby
losing weight, and is afraid to used the FF more since it takes so long and
baby does not take much.
I WOULD BE looking at what is really going on with this baby, with regard
to its respiration, feeding and latch. What does the baby do at breast?
All feeds are a little FF, and mostly bottle, with
night feeds all bottle. Mom's MD said he 'could not recommend' and drugs to
bring in milk ( we had talked about domperidone) and mom started red rasp.
tea two cups a day, yesterday.
SHE SHOULD have a thyroid test and be checked for retained placenta. Perhaps
she is just so freaked that it is inhibiting her milk, or perhaps she is one
of the very rare mothers who doesn't get milk for whatever reason, physical
or otherwise.
Mom is feeling "like a loser who has to use
that smelly stuff". I have praised all her efforts and all the drops and all
the close skintoskin. I wish I had a wand to bring in some milk for her. We
also discussed possibly FFing at breast when baby settles ( the first day
home from the hospital was disastrous) and puts on a little more weight, so
Mom feels less terrified, and keeping up her loving attentive mothering
skills. I am being supportive, but I wish I could offer her something that
would work! I am thinking of calling the OB, since the PED would not consider
the meds, but don't know if that would only get her hopes up, not knowing if
a. he would consider it or b. it would help. Comments?
Judy LeVan Fram, Brooklyn, NY
IF SHE has never noticed any breast changes, then has she had fertility
problems?
SORRY. I have more questions than I do answers...but skin to skin, pumping
frequently, and lots of baby at breast even if it is to cuddle and nuzzle
cannot hurt.
Kathleen
Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet, Indep. Consultant
mailto:[log in to unmask]
http://homepages.together.net/~kbruce/kbblact.html
LACTNET Archives http://peach.ease.lsoft.com/archives/lactnet.html
***********************************************
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
|
