In a message dated 9.9.03 3:49:02 PM, [log in to unmask] writes:


> Baby was =
> exclusively bf til about a week when he was weighed in the local baby =
> clinic just under d/c weight. (3. kgs)  . Baby would nurse and fall =
> asleep, wake, nurse and fall asleep, no real audible swallowing going =
> on,<<
> 
I know that you are worried about the accuracy of your scale but it sounds as 
if it is likely that the scale is correct.
Nursing the baby for as long and as often as he will stay attached won't 
*work* if the baby is moving little or no milk. We know that the baby was 
ineffective p/t to the start of bottles and based on your description of the consult, 
little has changed.   I would concentrate on moving the milk in the most 
effective way possible. This MIGHT be accomplished at the breast with compression, 
frequent position changes ie. change breast and position once swallowing 
subsides (use f-ball and xcradle holds), end feeding when little milk is transfered 
and pump after each feed during day. Despite adding extra positions to the 
feeding, total time spent at the breast with this regime is usually less then 
what was done prior as the Mom concentrates on changing once swallowing is no 
longer detected. Continue supplementing with bottles at night til wt gain is 
established.
your write;
>>we decided to feed him with a tube at the breast ebm<<
Did this help?
 Feeding tube use at breast should be very efficient ie. it moves milk 
quickly, if not something isn't right with setup etc.

you also write;
>>no real audible swallowing going =
on, but definite signs of milk transfer. occasional gulp.<<

I'm curious to know, if there were no audible swallows-what were the definite 
signs of milk transfer?

Lynn Shea Rn,Bsn,Ibclc
Franklin,Massachusetts


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