I just had another slightly pre term baby cause alittle problem. It seems
those at around 36 weeks often have problems with either feeding vigoruosly
or gaining wieght or both.
This most recent baby wasnt as much trouble as others. I D/C him from the
hospital at 48 hrs at 91.8% of BW mostly becuase mom was getting
"hospitalitis".
Because insurance wouldnt cover a visiting nurse I saw mom/baby today. Baby
was urinating well (cloth diapers) but only one brown/black stool in past 24
hrs. Baby was 90.6%of BW now at 72hrs old. Mom not feeling breast changes.
Baby's exam normal with mild juandice.
I recommended supplimenting to mom and showed her and dad supplimenting at
the breast and finger feeding. I used glucose water.
On leaving the office mom said breast were starting to feel full/warm.
This  evening I called and mom said her husband was out at the time and she
couldnt tape the catheter to her breast and didnt suppliment. (I had advised
suppliment every other feed.) She feels her milk has increased and can
express milk also the baby fed and spit up some milk. Baby urinating but no
stool yet. I told her she can hold off supliments and I'll see them
tomorrow.
These babies seem to cause problems alot.
Any ideas on dealing with them? Have mom start pumping between feeds after
delivery?
BTW no, infant wasnt in mom's room over night. I going to put up one of
those "bang head here signs."
-Rob
(pediatrician, Wilkes Barre PA)