An update on the 11 lb baby who was 10 oz below birthweight at 4
weeks.  At the time I wrote I had not seen them, only contact on the
phone.  This mother lives in a rural area and had a predominantly
midwife assisted delivery in a small birth centre not far from her
home (I was on a committee that allocated the funding for this
resource).  Labour was 3 1/2 hours, no medication, no complications,
no equipment, local doctor arrived for last 15 minutes.

The baby sounds from her description as if he was very puffy,
although otherwise well.  She said his eyes were like slits.  They
only weighed him at delivery and not again even though she stayed in
for eight days just resting and breastfeeding (eat your hearts out).
I don't know whether to be cross that they didn't keep weighing him,
or pleased that we have finally moved away from weight being the
ruling factor.  Anyway, his other signs were monitored and everyone
was happy with him, with no cause for concern.

This large little guy breastfeeds like he was born to do nothing
else.  She has perfectly shaped nipples, positioning and latch are
excellent.  His tongue is a little short, but over the lower gum. He
copes well with a rather forceful letdown.  He looks well (alertness,
skin turgor, hydration etc), sleeps quite a lot during the day
and feeds all night (co-sleeping).  Mother is determined to
breastfeed *until he goes to Uni* as she finished up bottlefeeding
her previous two after many problems.  She is really enjoying him and
does not want to revisit pumps, SNS, syringes, etc.  The consult was
a real pleasure.

I have noted all your suggestions, but I am more and more convinced
he was a bloated baby who lost 10% or more of his body weight and is
taking a while to regain it.  Mother is monitoring his hydration and
his stool/urine output, waking him to increase daytime feeds, and
otherwisejust enjoying him.  She lives a long way from a pair of
scales and wants to keep it that way.  The Child Health Nurse visits
the area weekly so we have another week to wait for a weight check.
I'll keep you posted.   Thanks for all the ideas.

Ros Escott
Tasmania, Australia