Hello.  I'm needing help with a patient and welcome your wisdom!  I have 
permission to post.

This mom delivered on 2/20/06, second child, uncomplicated pregnancy and 
delivery.  Birth weight 7# 4 oz.  Discharge weight at 48 hours 6# 11 oz.  
2 days later at her home visit infant weight was 6-10, the following day 
weight remained the same.  On day 9 infant weighed 6-11.7 (pre-feeding) 
and 6-12.2 (after nursing for 15 mins on one side)  Infant then nursed for 
5 mins on other side and weight went to 6-12.3.  Mom has to continually 
stimulate infant while she is at the breast to keep her actively 
suckling.  Infant latch appears to be good although mom does have rather 
large nipples.  Mom pumped after pre and post wt. and got 1 oz from each 
side (used Lactina).  Mom encouraged to continue to nurse infant 8-12 
times every 24 hours.  Mom stated she had been pumping with manual pump at 
home occasionally and was giving 1/2 oz of breastmilk per dropper 1-2 
times per day.  

I spoke with mom on day 11 and she said that infant was nursing better 
(staying awake more) but she continued to give 1/2 oz by dropper 2 times 
per day.  Pt stated she felt that her infant was gaining wt. and had a 
weight check the following Monday.  Today infant went for weight check, 
infant is 2 weeks old, and weight was 6# 6 oz.  Mom is beside herself and 
states this same thing happened with her son.  Her ped recommended 
supplementing formula 2 times per day, starting with 2 oz. per feeding.  
Mom is questioning if her milk is "bad".  We discussed using a SNS, mom 
asked about continuing to use the dropper, and discussed using pumped 
breastmilk vs. formula.  Infant is having 6+ wet diapers per day but 
stools are infrequent and are brown/mucousy.  I welcome any input, and 
apologize in advance if I've been too vague with details!
Thank you for your advice and support,
Michelle 

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