Thank you, Rachel. This mom does not want to see an other LC. She is doing 
2x per day pumping, and feeding the baby the milk via syringe. She does this 
after a feeding, and gets about an oz or a little more, of nice, creamy hind 
milk. Sometimes the baby wants it, sometimes he refuses it, or spits it. She 
assumes (I think correctly) that when he takes it, he may need it, and when 
he doesn't he doesn't need it. 

I haven't weighed him since Friday (his 28th day.) He had a 2.5 oz wet diaper. 
He had only gained a single oz since the previous Monday, but took in nearly 3 
oz from her breast, and Mom said, before the weigh, "This wasn't one of his 
better feedings, he was playing a lot." and then an other oz via syringe (I 
attempted cup feeding, which I usually have very good luck with, but he 
wanted nothing to do with it, screaming, while a little milk sat at the bottom of 
his mouth. His mom put it into a syringe, and he took about an oz.) He then 
had a huge stool blowout (and looked pretty relieved afterward.) Went 
through the diaper, the sleeper, the blanket, and all over Mom. She was so 
proud, that she saved the diaper to show dad. (He came over to tell my dh 
about it, in great detail the next day. :) ) The stool was normal, but large, and 
was his third stool of the day. (this was about 7 PM) He usually has good, 
large, totally adequate stools, but this one was tremendous. But, nice and 
yellow and seedy, not the green one sometimes sees with huge stools. 

Mom seems more relaxed, and agrees that he is a healthy, thriving baby. His 
Ped visit was moved to Thursday, per doctor's schedule, and maybe the pump 
and the few extra oz a day is giving her a little "safety net." 

He is very squirmy and hard to measure, (he nearly flips himself off the scale, 
if he doesn't want to be there, and can easily roll from his back onto his side, 
and nearly onto his tummy!) but I have seen this baby at least 5 times a week 
and I know he is much longer than at birth, and his head is growing. He has 
already outgrown a couple of newborn size sleepers, and can't wear the tiny 
newborn stocking caps on his head, due to growth.  I will hope to see him 
today, and attempt to actually get a measurement, however, he had grown at 
least an inch from birth, at his second doctor visit several weeks ago. He is a 
very active baby, who, most likely is using calories quickly. I have asked Mom 
and Dad to make sure to keep him warm, so he doesn't waste calories trying 
to keep warm (it's still cold in Chicago, and damp, and we live in old houses, 
which are drafty in our area, so I think keeping him warm is a good idea.) 

The only discomfort she is having is a transient ductal spasm. We have pretty 
much ruled out Thrush, as she has no nipple pain, the baby does not have a 
pearly membrane in his mouth and his diaper area appears fine. Mom also has 
no other symptoms of Thrush. This pain only occurs after the first feeding in 
the morning, and Tylenol seems to help almost completely, as well as warm 
compresses. (I've had Thrush, and even strong pain meds did nothing to 
relieve the burning, itching and misery.) 

I'll try to get an other weight and length check today, if possible. 

Thank you for your confidence. It is greatly appreciated. :)

Mary 

On Sat, 5 Apr 2008 18:51:59 +0200, Rachel Myr <[log in to unmask]> wrote:

>I'm still nomail, but this week I have been experiencing Lactnet right in my
>actual living room, as opposed to the virtual one.  Karleen Gribble came for
>a visit, which was made even more fun because Marit Olanders, editor of
>Swedish 'Amningsnytt', followed by Mia Westlund, my IBCLC/midwife partner in
>crime from Gothenburg, also managed to get here for overnight visits.  It
>was a mini-retreat for me - or maybe I should just start something called
>Rachel's B&B, where one of the B's is for breastfeeding discussion.
>
>Because of all these bothersome distractions I had not read anything at the
>archives in the past week, until today.  Mary Jozwiak case caught my eye.
>I noticed that this baby was long for his weight even at birth.  Both his
>parents were long, lean babies.  Is it possible to measure his length now?
>I am willing to bet he is at least an inch, and probably two, longer than he
>was when he was born.  I say this because all of the other things in the
>description of him sound like a thriving, healthy baby.  The pediatrician
>isn't finding anything the matter.  The baby is happy, developing normally
>in all other ways, he has unlimited access to the breast, he is producing
>urine and stools and mother is feeling no pain with feeds.
>
>I agree that when a baby hasn't regained his birth weight by three weeks, we
>need to investigate.  But when investigation fails to show anything other
>than a lean baby, there isn't much to do about it.  Every once in a while
>you meet someone who falls outside the bell curve, be it in income,
>niceness, number of books read in past year, how fast they can run 1000 m,
>or as in this case, weight.  It doesn't have to be pathology.  Some of us
>are just statistical outliers, and there is nothing to be gained by trying
>to make us be closer to some arbitrary average.
>
>Mary, while I would be concerned about all the finer details of his feeds if
>I felt there was a problem other than the slow weight gain, when I read your
>post, my concern vanished.  Therefore, I am not sure it is necessary to try
>to get him to swallow more milk than he is already doing or to behave in
>some other way at the breast - his behavior at the breast sounds entirely
>physiologic to me when I read your very clear description.  Babies latch on,
>they place their order for an MER and when it arrives they drink it down.
>If they want to order another MER serving, they hang out for longer, and
>unless the milk continues to flow rapidly between Mars so that they need to
>keep swallowing in the meantime, they just wait.  If they can't wait til
>that breast can muster a MER, they twist around to the other side and hang
>out there.  When they have had their fill, they come off.  It sounds to me
>like that is what he is doing.  I can understand your friend not being
>enthused at the prospect of trying to manipulate the composition of his
>feeds when it sounds like there may not be any reason for concern other than
>the percentile in which his weight falls.  Get a length measurement - and
>consider the possibility that there was something wrong with the scale when
>he was weighed at birth, or perhaps with the recording of that weight.  (But
>I bet the parents have a picture of him on the scale with the weight
>showing!)
>
>Just because the parents are good friends of yours doesn't mean that you are
>*missing* some glaring pathology due to your closeness to the family.
>Sounds like you have been extremely stringent in your assessment and they
>couldn't be getting better care anywhere.  So, maybe you deserve to just
>relax now?
>
>As far as his jaundice goes, as long as he is behaving as you describe I
>would not be concerned if the pediatrician isn't.  ABO incompatibilities
>rarely pose any threat to term babies and the ones with pathological
>jaundice don't act the way this baby does.
>
>Cheers
>Rachel Myr
>Ready for the next influx of Lactnetters, whenever that might be, in
>Kristiansand, Norway
>
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