Just wanted to share a postive day in the life of a Ped/LC.

I've been working with a challenging/rewarding BF couple.
T.J.'s birthweight was 6#12oz. He was seen at 2 weeks of age by another ped
with a 1# weight loss, down to 5#12oz. Fortunately, I saw the babe 6 days
later for a lactation consultation. Mom is a primip, very dedicated to BF but
with a somewhat overbearing,"did not BF is this worth the trouble", mother.
 Lots of personal stress on top of some latch problems and a fussy baby.  We
had a positive session and I asked to see the babe back in 3-5 days. At this
time his weight was 6#3oz. Unfortunately, they never came back in until now
at 2 months of age. His weight was 6#13oz - only 1oz over birthweight!!!! The
history was that the babe was always hungry, seemed eager to BF, would only
suck about 5-10 minutes and then fall asleep. He had 6-7 wet diapers/day but
only one small stool/day. I observed a nice latch and a mom with a good milk
supply. She was also intermittently pumping 2-3oz at a time. The pediatrician
side of me is looking at a FTT and I'm worried about all the metabolic or
other potentially serious medical  diagnoses. But besides being thin, this
kid was vigorous with a strong suck and good tone. No murmur, no enlarged
liver, nothing that grabbed me as really "abnormal." I resisted the urge to
hospitalize (which I really caught some flack for) and did outpatient
screening labs. Somehow I felt that this babe was taking "everything off the
top" and never getting down to the denser, rich hindmilk. I was pretty
worried, as was the family. The labs were all normal, no evidence of acidosis
or dehydration. I trusted my instincts decided to give him a week on a new
feeding schedule. I had mom keep him on the first breast as long as she could
then switch if he was still interested. She started more freq. pumping and
offering the  hind milk after BF with a NUK nipple/bottle. Grandma thought I
was nuts for not just putting him on ABM, but I felt the mom really wanted
this to work (and so did I!). He came in today and weighed 8#7oz!! A gain of
1#10oz in ONE WEEK. I've never seen this before. We were all near tears of
joy. He looks great!

My other uplifting experience of the day is a mom who had breast reduction
surgery 8 years ago and now is producing LOTS of milk. She had the "below the
breast and up and around the areola"incision. She was told by her OB to just
forget about BF (how terribly supportive) but I gave her the OK to go ahead
and "secretly" pump. The baby is now 4 days old, she actually felt some
engorgement and he is going right for the breast and wants nothing to do with
the ABM. What a bright kid!

Days like today make it all worthwhile............

Karen J. Stepan, DO, IBCLC
[log in to unmask]