Guest guest Posted March 29, 2011 Report Share Posted March 29, 2011 Seizures in infants can be very serious. There are videos online that can help this mother identify if it is a seizure. I'm at the dentist and don't have access to link right now so let me know if you needote specifics and I can gat back to it later. Sent from my iPhone Hello Wise Ones! I was fortunate to see a mom with her 4 day old nursling today. While baby is quite sleepy and mom's milk hasn't yet come in, everything else about this pair looks great: nice latch, nice anatomy, great bonding. The mom mentioned to me that when she was at the peds visit yesterday, she mentioned to the PA that the baby seems to have "tremors". The PA said that it was most likely due to low blood sugar and did a glucose test. The levels were normal though but to be on the "safe side" ;-) they have recommended 0.5 ounce of formula after every feed. I did observe the tremors that the mother described. However, I think I've seen this or read about this before. Could this possibly be neurological immaturity and NOT a sugar issue? If so, I would like to offer her some research to back this up. Mom was induced and birthed the babe at 39 weeks. It seems that if the medical establishment's diagnostic tool says one thing, why would they state another? Thanks for your help! IBCLC, LLLL Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 29, 2011 Report Share Posted March 29, 2011 many babies do that in the first few days. keep him swaddled! he'll feel safer and less startly. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comBreastfeeding Between the Lines: http://second9months.wordpress.com/Facebook: www.facebook.com/thesecond9months--- Subject: Tremors?To: Date: Tuesday, March 29, 2011, 11:55 AM Hello Wise Ones! I was fortunate to see a mom with her 4 day old nursling today. While baby is quite sleepy and mom's milk hasn't yet come in, everything else about this pair looks great: nice latch, nice anatomy, great bonding. The mom mentioned to me that when she was at the peds visit yesterday, she mentioned to the PA that the baby seems to have "tremors". The PA said that it was most likely due to low blood sugar and did a glucose test. The levels were normal though but to be on the "safe side" ;-) they have recommended 0.5 ounce of formula after every feed. I did observe the tremors that the mother described. However, I think I've seen this or read about this before. Could this possibly be neurological immaturity and NOT a sugar issue? If so, I would like to offer her some research to back this up. Mom was induced and birthed the babe at 39 weeks. It seems that if the medical establishment's diagnostic tool says one thing, why would they state another? Thanks for your help! IBCLC, LLLL Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 29, 2011 Report Share Posted March 29, 2011 Hi ,The tremors may in fact be low blood sugars. They may have gotten a normal blood sugar reading if the infant had recently nursed. Sugars will go up and down on people during the course of the day--it may be a question of timing. The sleepiness of the baby also makes me suspicious--this can be a symptom of low blood sugar. Certain clinical situations--diabetic (gestational or otherwise) mothers, a large or small for gestational age baby, illness or infection, can also influence blood sugars and cause problems. Were any of these the case for this infant-mother pair? I am not a pediatric practitioner, however, I'm pretty sure if blood sugars are labile at the 4th day of life this baby should be evaluated more intensively. Simply throwing formula at the issue may be masking a more severe clinical problem. Did she give the formula? Have the tremors resolved with getting formula? As for the tremors being related to neurological immaturity, I don't know as much about that, but it seems unlikely at 39 weeks gestation. Do you know why she was induced? In the meantime, if in case it is the blood sugars, I'd advise mom to keep the baby on the breast as much as possible. It will even out the blood sugars, and hopefully, mom's milk will come in more quickly with frequent nursing. If the baby is too sleepy to nurse, that's another red flag that baby needs further evaluation asap. Good luck,, RN, IBCLC in NYCHello Wise Ones!I was fortunate to see a mom with her 4 day old nursling today. While baby is quite sleepy and mom's milk hasn't yet come in, everything else about this pair looks great: nice latch, nice anatomy, great bonding.The mom mentioned to me that when she was at the peds visit yesterday, she mentioned to the PA that the baby seems to have "tremors". The PA said that it was most likely due to low blood sugar and did a glucose test. The levels were normal though but to be on the "safe side" ;-) they have recommended 0.5 ounce of formula after every feed.I did observe the tremors that the mother described. However, I think I've seen this or read about this before. Could this possibly be neurological immaturity and NOT a sugar issue? If so, I would like to offer her some research to back this up. Mom was induced and birthed the babe at 39 weeks. It seems that if the medical establishment's diagnostic tool says one thing, why would they state another?Thanks for your help! IBCLC, LLLL Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 29, 2011 Report Share Posted March 29, 2011 , It didn't " seem " like what I know and perceive a seizure to be. However, I will look for something online. Thank you for the direction. , these slight tremors happened whether or not the baby was swaddled or in the mom's arms. The mom did say repeatedly that she initially thought the tremors were a shiver because she first saw it when the baby was cold. But that isn't always the case. Francesca, none of those clinical situations are present in this dyad (small/large for gestational age, diabetic, illness, injury) which is why this has me wondering. Also, the induction was for the mom's personal reasons and not medical ones. Thanks, ladies, for giving me some more food for thought. . . IBCLC, LLLL > > > Hello Wise Ones! > > > > I was fortunate to see a mom with her 4 day old nursling today. > > While baby is quite sleepy and mom's milk hasn't yet come in, > > everything else about this pair looks great: nice latch, nice > > anatomy, great bonding. > > > > The mom mentioned to me that when she was at the peds visit > > yesterday, she mentioned to the PA that the baby seems to have > > " tremors " . The PA said that it was most likely due to low blood > > sugar and did a glucose test. The levels were normal though but to > > be on the " safe side " ;-) they have recommended 0.5 ounce of formula > > after every feed. > > > > I did observe the tremors that the mother described. However, I > > think I've seen this or read about this before. Could this possibly > > be neurological immaturity and NOT a sugar issue? If so, I would > > like to offer her some research to back this up. Mom was induced and > > birthed the babe at 39 weeks. It seems that if the medical > > establishment's diagnostic tool says one thing, why would they state > > another? > > > > Thanks for your help! > > > > IBCLC, LLLL > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 29, 2011 Report Share Posted March 29, 2011 A baby with a metabolic disorder can get high ammonia levels that lead to seizures. They are typically lethargic which moms perceive as sleepy. The more protein/amino acids they take on the worse they become. Any question of seizure activity should be evaluated. Did her newborn screening results come back?Sent from my iPhone Seizures in infants can be very serious. There are videos online that can help this mother identify if it is a seizure. I'm at the dentist and don't have access to link right now so let me know if you needote specifics and I can gat back to it later. Sent from my iPhone Hello Wise Ones! I was fortunate to see a mom with her 4 day old nursling today. While baby is quite sleepy and mom's milk hasn't yet come in, everything else about this pair looks great: nice latch, nice anatomy, great bonding. The mom mentioned to me that when she was at the peds visit yesterday, she mentioned to the PA that the baby seems to have "tremors". The PA said that it was most likely due to low blood sugar and did a glucose test. The levels were normal though but to be on the "safe side" ;-) they have recommended 0.5 ounce of formula after every feed. I did observe the tremors that the mother described. However, I think I've seen this or read about this before. Could this possibly be neurological immaturity and NOT a sugar issue? If so, I would like to offer her some research to back this up. Mom was induced and birthed the babe at 39 weeks. It seems that if the medical establishment's diagnostic tool says one thing, why would they state another? Thanks for your help! IBCLC, LLLL Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 30, 2011 Report Share Posted March 30, 2011 Tremors can also be from low body temperature or from mild seizure activity. Gail Neuman RNC BSN CPHWcertified in high risk OBchildbirth/lactation educator & student nurse practitionerAHA BLS for Healthcare & Heartsaver Family/Friends instructor after 2/23/11 Perinatal Nurse Associates Baby Your Way Midwifery Associates801 N. Tustin Ave., Suite 305Santa Ana, CA 92705 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 30, 2011 Report Share Posted March 30, 2011 , newborns don't have the ability to shiver-that takes I think about 2 years to develop. Gail Neuman RNC BSN CPHWcertified in high risk OBchildbirth/lactation educator & student nurse practitionerAHA BLS for Healthcare & Heartsaver Family/Friends instructor after 2/23/11 Perinatal Nurse Associates Baby Your Way Midwifery Associates801 N. Tustin Ave., Suite 305Santa Ana, CA 92705 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 30, 2011 Report Share Posted March 30, 2011 WE have most certainly left the " safe side " when we introduce AIM as an intervention!!! Tow, IBCLC, France > > Hello Wise Ones! > > I was fortunate to see a mom with her 4 day old nursling today. While baby is quite sleepy and mom's milk hasn't yet come in, everything else about this pair looks great: nice latch, nice anatomy, great bonding. > > The mom mentioned to me that when she was at the peds visit yesterday, she mentioned to the PA that the baby seems to have " tremors " . The PA said that it was most likely due to low blood sugar and did a glucose test. The levels were normal though but to be on the " safe side " ;-) they have recommended 0.5 ounce of formula after every feed. > > I did observe the tremors that the mother described. However, I think I've seen this or read about this before. Could this possibly be neurological immaturity and NOT a sugar issue? If so, I would like to offer her some research to back this up. Mom was induced and birthed the babe at 39 weeks. It seems that if the medical establishment's diagnostic tool says one thing, why would they state another? > > Thanks for your help! > > IBCLC, LLLL > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 31, 2011 Report Share Posted March 31, 2011 ,Did you look into medications or drugs taken by the mother during pregnancy and for which the infant may be displaying withdrawal symptoms ? Ghislaine Reid, IBCLCConsultante en lactationLactation Consultant De : [mailto: ] De la part de Envoyé : 29 mars 2011 15:41À : Objet : Re: Tremors? Hello Wise Ones!I was fortunate to see a mom with her 4 day old nursling today. While baby is quite sleepy and mom's milk hasn't yet come in, everything else about this pair looks great: nice latch, nice anatomy, great bonding.The mom mentioned to me that when she was at the peds visit yesterday, she mentioned to the PA that the baby seems to have " tremors " . The PA said that it was most likely due to low blood sugar and did a glucose test. The levels were normal though but to be on the " safe side " ;-) they have recommended 0.5 ounce of formula after every feed.I did observe the tremors that the mother described. However, I think I've seen this or read about this before. Could this possibly be neurological immaturity and NOT a sugar issue? If so, I would like to offer her some research to back this up. Mom was induced and birthed the babe at 39 weeks. It seems that if the medical establishment's diagnostic tool says one thing, why would they state another?Thanks for your help! IBCLC, LLLL Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 31, 2011 Report Share Posted March 31, 2011 Nicotine withdrawal can appear this way at times as well. Babies experiencing nicotine withdrawal are often hypertonic, have a high pitched cry, and jittery. I would like to add that 'supplement' does not necessarily equate to 'formula'. My experience is that unfortunately when HCP's are considering 'supplement' somehow it is believed that this supplement must be formula (not addressing whether this recommendation was appropriate or not). Supplement, in most cases, can be expressed mother's milk. > > , > > Did you look into medications or drugs taken by the mother during pregnancy > and for which the infant may be displaying withdrawal symptoms ? > > > > Ghislaine Reid, IBCLC > > Consultante en lactation > > Lactation Consultant > > > > De : [mailto: ] De la part > de > Envoyé : 29 mars 2011 15:41 > À : > Objet : Re: Tremors? > > > > Hello Wise Ones! > > I was fortunate to see a mom with her 4 day old nursling today. While baby > is quite sleepy and mom's milk hasn't yet come in, everything else about > this pair looks great: nice latch, nice anatomy, great bonding. > > The mom mentioned to me that when she was at the peds visit yesterday, she > mentioned to the PA that the baby seems to have " tremors " . The PA said that > it was most likely due to low blood sugar and did a glucose test. The levels > were normal though but to be on the " safe side " ;-) they have recommended > 0.5 ounce of formula after every feed. > > I did observe the tremors that the mother described. However, I think I've > seen this or read about this before. Could this possibly be neurological > immaturity and NOT a sugar issue? I Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 1, 2011 Report Share Posted April 1, 2011 Thank you all for your wealth of information and wisdom! The mother is, and was, a non-smoker. No medications- prescription or otherwise -were mentioned to me (other than pre-natal vit). The doctor doesn't seem overly concerned even though the formula (and yes, the PA said " formula " not just a supplement of EBM) didn't seem to make a difference regarding the tremors. In addition since our visit, the mother's milk has come in and she has discontinued the formula use. She's also stated that the baby is less sleepy than before. I plan to follow up again with her in a few days. This tremor situation may just remain one of the many mysteries of life but I do so appreciate all of your concern. IBCLC, LLLL > > > > , > > > > Did you look into medications or drugs taken by the mother during pregnancy > > and for which the infant may be displaying withdrawal symptoms ? > > > > > > > > Ghislaine Reid, IBCLC > > > > Consultante en lactation > > > > Lactation Consultant > > > > > > > > De : [mailto: ] De la part > > de > > Envoyé : 29 mars 2011 15:41 > > À : > > Objet : Re: Tremors? > > > > > > > > Hello Wise Ones! > > > > I was fortunate to see a mom with her 4 day old nursling today. While baby > > is quite sleepy and mom's milk hasn't yet come in, everything else about > > this pair looks great: nice latch, nice anatomy, great bonding. > > > > The mom mentioned to me that when she was at the peds visit yesterday, she > > mentioned to the PA that the baby seems to have " tremors " . The PA said that > > it was most likely due to low blood sugar and did a glucose test. The levels > > were normal though but to be on the " safe side " ;-) they have recommended > > 0.5 ounce of formula after every feed. > > > > I did observe the tremors that the mother described. However, I think I've > > seen this or read about this before. Could this possibly be neurological > > immaturity and NOT a sugar issue? I > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 1, 2011 Report Share Posted April 1, 2011 Oh I believe that! I don't mean to beat a dead horse.....what you have described is so typical. Which was why I commented, the HCP's just assume that any supplementation must be done with formula. Not addressing whether it is warranted, and this may not apply to your case, but just trying to throw it out there, my response to these instructions is to encourage people to ask, " ....is there any reason why the mother may not supplement using her own expressed milk? " . Almost universally the response I get from the HCP, is, " ...oh yeah, that would be fine " . But it's THEM who assume supplements = formula, and sometimes we can help redirect this to use of EMM. Just a suggestion for us to consider. I always clarify this with the HCP's I work with, and I really cannot think of any case where a HCP declined to use EMM as supplement, it's just not how they think....where we think EMM, get mom hand expressing, and pumping, they just think formula. > > > > Nicotine withdrawal can appear this way at times as well. Babies experiencing nicotine withdrawal are often hypertonic, have a high pitched cry, and jittery. > > > > I would like to add that 'supplement' does not necessarily equate to 'formula'. My experience is that unfortunately when HCP's are considering 'supplement' somehow it is believed that this supplement must be formula (not addressing whether this recommendation was appropriate or not). Supplement, in most cases, can be expressed mother's milk. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 2, 2011 Report Share Posted April 2, 2011 Hmmm....I have to disagree. If a baby needs more food than he is taking directly from the breast, then he is being supplemented -- either with his MOM, or with donor breastmilk, or with formula. A baby in this situation needs evaluating as to why he can't take all he needs from the breast. Now, if mama is at work, and she pumps and someone gives it to him in a bottle, then I don't consider that supplementation -- that is feeding breastmilk, but other than from the breast. If she doesn't pump, and gives formula while she is gone, then I don't consider that supplementation either. Depends entirely on the situation. Jan I personally do not consider EBM as a supplement. It's just a continuation of breastfeeding via a bottle, cup or spoon. A supplement is some other form of nutrition given after or in between feedings. Gail Neuman RNC BSN CPHW certified in high risk OB childbirth/lactation educator & student nurse practitioner AHA BLS for Healthcare & Heartsaver Family/Friends instructor after 2/23/11 Perinatal Nurse Associates Baby Your Way Midwifery Associates 801 N. Tustin Ave., Suite 305 Santa Ana, CA 92705 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 2, 2011 Report Share Posted April 2, 2011 I personally do not consider EBM as a supplement. It's just a continuation of breastfeeding via a bottle, cup or spoon. A supplement is some other form of nutrition given after or in between feedings. Gail Neuman RNC BSN CPHW certified in high risk OB childbirth/lactation educator & student nurse practitioner AHA BLS for Healthcare & Heartsaver Family/Friends instructor after 2/23/11 Perinatal Nurse Associates Baby Your Way Midwifery Associates 801 N. Tustin Ave., Suite 305 Santa Ana, CA 92705 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 2, 2011 Report Share Posted April 2, 2011 I feel the same way Jan. I always tell moms, anything that isn't taken directly from your breast by the baby is a supplement. otherwise they are confused and don't give me accurate information about what's going on with breastfeeding--only counting "supp" as formula. and yes, if mom is away from baby it's a different story! Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comBreastfeeding Between the Lines: http://second9months.wordpress.com/Facebook: www.facebook.com/thesecond9months--- Subject: Re: Re: Tremors?To: Date: Saturday, April 2, 2011, 10:39 AM Hmmm....I have to disagree. If a baby needs more food than he is taking directly from the breast, then he is being supplemented -- either with his MOM, or with donor breastmilk, or with formula. A baby in this situation needs evaluating as to why he can't take all he needs from the breast. Now, if mama is at work, and she pumps and someone gives it to him in a bottle, then I don't consider that supplementation -- that is feeding breastmilk, but other than from the breast. If she doesn't pump, and gives formula while she is gone, then I don't consider that supplementation either. Depends entirely on the situation. Jan I personally do not consider EBM as a supplement. It's just a continuation of breastfeeding via a bottle, cup or spoon. A supplement is some other form of nutrition given after or in between feedings. Gail Neuman RNC BSN CPHW certified in high risk OB childbirth/lactation educator & student nurse practitioner AHA BLS for Healthcare & Heartsaver Family/Friends instructor after 2/23/11 Perinatal Nurse Associates Baby Your Way Midwifery Associates 801 N. Tustin Ave., Suite 305 Santa Ana, CA 92705 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 2, 2011 Report Share Posted April 2, 2011 Most breastfeeding literature and texts refer to 'supplement' as meaning 'in addition to' (I don't know of any that do not refer to it in this context but I've left margin for that!). I agree with Jan and my experience with the use of this language is that almost universally the term 'supplement' is used as a reference to nourishment that is provided in addition to breastfeeding but is rarely used to express the 'source' of the supplement meaning formula or mother's milk. michelle > > Hmmm....I have to disagree. If a baby needs more food than he is taking > directly from the breast, then he is being supplemented -- either with his > MOM, or with donor breastmilk, or with formula. A baby in this situation > needs evaluating as to why he can't take all he needs from the breast. > > Now, if mama is at work, and she pumps and someone gives it to him in a > bottle, then I don't consider that supplementation -- that is feeding > breastmilk, but other than from the breast. If she doesn't pump, and gives > formula while she is gone, then I don't consider that supplementation either. > > Depends entirely on the situation. > > Jan > > > In a message dated 4/2/2011 12:31:01 P.M. Central Daylight Time, > gin11153@... writes: > > > > > I personally do not consider EBM as a supplement. It's just a continuation > of breastfeeding via a bottle, cup or spoon. A supplement is some other > form of nutrition given after or in between feedings. > > > > > > > > > > > Gail Neuman RNC BSN CPHW > certified in high risk OB > childbirth/lactation educator & student nurse practitioner > AHA BLS for Healthcare & Heartsaver Family/Friends instructor after 2/23/11 > > > Perinatal Nurse Associates > > Baby Your Way Midwifery Associates > 801 N. Tustin Ave., Suite 305 > Santa Ana, CA 92705 > (714) 337-7979 > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 2, 2011 Report Share Posted April 2, 2011 I agree with Jan. I have gotten very confused in earlier days when a mother would say she is not supplementing, so I assume (on the phone) that baby is getting all he needs at breast, and then later she says baby nurses and then takes 3 oz from a bottle before he is satisfied! OK, I get that it's all breastmilk, but we've got a very different situation if baby is getting everything from the breast *himself* or if it's right there waiting for him and he needs to be given it in some other fashion. Now I know to specifically ask *how* he is getting the breastmilk! And if he can't get it from the breast himself (when he's right there, not if mother is away at work or whatever), then he is being supplemented and there is something that needs to be looked into. Dee KassingHmmm....I have to disagree. If a baby needs more food than he is taking directly from the breast, then he is being supplemented -- either with his MOM, or with donor breastmilk, or with formula. A baby in this situation needs evaluating as to why he can't take all he needs from the breast. Now, if mama is at work, and she pumps and someone gives it to him in a bottle, then I don't consider that supplementation -- that is feeding breastmilk, but other than from the breast. If she doesn't pump, and gives formula while she is gone, then I don't consider that supplementation either. Depends entirely on the situation. Jan I personally do not consider EBM as a supplement. It's just a continuation of breastfeeding via a bottle, cup or spoon. A supplement is some other form of nutrition given after or in between feedings. Gail Neuman RNC BSN CPHW Quote Link to comment Share on other sites More sharing options...
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