There have been some recent posts about this type of situation. Malnutrition 
can occur in the mom. However, the first thing I would do would be to take a 
thourough history and an in-person bf evaluation. Of note is that the baby 
is a 37 wk'er. Was the baby small in size?
Did the baby begin bf immediately after birth? How did the early feeds go? 
Was the birth complicated? Was the birth surgical? How has mom's health been 
since the bypass? Is she anemic for example? Is mom on any meds? Cold meds, 
birth control?

Did the baby EFFECTIVELY feed ALL feeds in hospital? Have any feedings been 
evaluated by a SKILLED BF HELPER? Were they exclusively bf? Did mother 
experience onset of copious milk production around day 3 or 4? And so on. In 
my experience, these are usually the factors that contribute to the poor 
gain.

Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA

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