Hello to all of you who didn't go to Boca,
I have a problem I would like to share and maybe get some help from you.
Mom's third baby. First two bf for at least a year, no problems. Mom first
called abouth this baby when she was three weeks old because she didn't
gain weight. Baby born at term, normal delivery, 3,300gr, down to 3,000,
and 3,000 at three weeks. Mom said baby nursed well, about every 3-4 hrs,
sleeps well, good suck and she hears swallowing, BUT poops only once every
3-4 days.
I suggested feeding every two hrs, let baby finish first side, pay
attention to positioning and latch on, get checked by pediatrician, and
close followup.
Baby gained 100gr next week, but nothing again the week after. I
recommended an IBCLC in their area. Th LC saw a very thin baby, with
disorganized suck, keeps pulling of all the time, almost no swallowing, a
slightly receding chin. I haven't seen them due to distance, and this
teaches us again about the dangers of phone consultations - mom felt baby
was nursing OK. I was in touch with the LC.
LC gave some advice about positioning and latch, and told mom to FEED THE
BABY, and so did I.
Mom started supplementing with 50gr ABM 5 times a day with bottle, and
continued nursing every two hrs. Next week baby gained 300gr, but the next
few weeks only 100gr or less per week, and gained nothing the last week,
with the same supplement.
Baby now 2 mnths old, 4000gr (at birth 3,300, down to 3,000)
They saw a peditric gastroenterologist yesterday, and he said baby has to
get 150gr milk 6 times a day. He knows this will end nursing, but is
concerned about the baby, and has no other solution.
I suggested pumping to get supply up, and to use EBM as supplement, but mom
is physically very uncomfortable pumping - hurts, pulls to much, and almost
no milk. She tried the Medela mini elecctric. This is the best pump
available here in Israel. I knnow only of one LC renting PNS or Lactina,
and she went to the US for the summer, and so did the LC they saw in the
beginning. (They will probably be in Boca...). She didn't get any
instuctions how to pump, and tried only once or twice, because of the pain.
My questions are:
- Any chance that the suck may still improve at this age - 2 mnths?
- What can be done to improve the suck - maybe osteopathic tmt?
- Any ideas on making pumping more comfortable? Mom is very dedicated to
bf, and would at least like her baby to have EBM.
- Could Domperidone help the supply at this stage, assuming mom will be
able to pump, or baby's suck will improve? I think I read that this is
useful only in the first weeks.
Any other ideas will be welcome.
About the mother with recurrent mastitis and abcess I asked about a while
ago - thanks to all those writing me. Sorry for not answering sooner. She
went on nursing, taking care to drain the breast well. Haven't heard from
her since. Will let you know any developments.
Thanks again for all your help.
Mira Leibovich, MD
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