Hi Michelle
It sounds like there is a milk transfer problem here - possibly coupled with
an easy-going personality. (Transitional stools after day five.) I would
want to see the baby at the breast. Is the baby wrapped tightly around the
mother's body (chest to chest - chin to breast) or lying prone on her
mother's abdomen while she feeds? Can you observe a change in the suckling
pattern associated with let-down? Is the baby actively sucking after that?
Can you observe her chin pause at the bottom of her sucking action? Can you
hear her swallow? What happens if mum does breast-compressions while
feeding? Do bub's hand and face relax through the course of the feed? Do
mum's breasts feel softer after the feed than they did before? Are there
any signs of nipple trauma?
How is the supplementary ebm feed being offered? Bottle? Cup? SNS? Is baby
to too worn-out to want to take the supplement? Perhaps the ebm could be
offered during one of those alert times? Is mum co-sleeping with bub? This
can increase the frequency of feeding overnight at a time when mum is
relaxed.
Nina Berry BABEd(Hons) DipArts(Phil)
Cert IV Breastfeeding Education (Counselling & Community)
Australia
-----Original Message-----
From: Lactation Information and Discussion
[mailto:[log in to unmask]] On Behalf Of Michelle Scott
Sent: Monday, November 24, 2008 10:09 AM
To: [log in to unmask]
Subject: 11 days and no yellow stool
Help. I have a mom who is nursing every 2 -3 hours, pumping after most
feeds since the baby lost >10% at 5 d wt ck.
No stool at 5 d, though plenty of stools in hospital. Now over the past 6
days, she had one day with 3 dark brown "diarrhea" (per parent's
description), and now no stool for 55 hours. Still nursing, but quite
sleepy during feeds. Mom only gets 1/4 to 1/2 oz per pumping after a feed,
and has been offering 1 oz or so after feeds at the breast, but says baby
usually won't take it. 2 visits to pediatrician so far, with one coming up
tomorrow. No stool today.
Any ideas? No jaundice, baby has an alert time 2-3 times where she is
content to interact with parents.
Michelle Scott, MA, RD, IBCLC
Wellspring Nutrition and Lactation Services
632 Sand Pit Road
Mason, NH 03048
603 801-9140
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