Re: Digest Number 457

[Guest guest]

I definately agree with Marsh and Donna.

Obviously look at 'why' - like birth control pills, thyroid issues etc.

I would say if either weight gain or milk supply is an issue then a

minimum of 8 feeds in 24 hours is needed.

Around 6- 12 weeks the prolactin is reducin to pre-prgnancy levels and

this could now have 'bottomed out'.

I would suggest that mum has a 'one week' plan (to start with). Look at

positioning and attachment - less than optimal means less stimulation and

less milk and less weight gain - check out oral structures for tongue tie,

high arched palate etc. which may mean an adjustment to p & a. After a feed

I would wait for 10 minutes and offer more on the other side (if not

superswitching), then express for up to 20 mins alternating from side to

side regardless of output, but for stimulation. I would suggest removal

of pacifier and allow mum to be used instead - if he's sucking he should

be stimulating! And up the number of feeds.

It sound like the baby is going 'shut down' as a preservation instinct and

simply hasn't had enough food to give him the energy to wake up and ask to

be fed - so he need help and a nudge to do so.

Don't forget with a bottle a baby will almost alwyas take an extra 1 more

than he needs because he doesn't get the gag (I'm full) reflex from a

bottle teat so he fills not only his stomach but up to his neck! and then

of course sleeps for longer and takes in less milk at the breast!

Best Wishes

Pam Lacey IBCLC

in the UK