Tonight we visited a mom who IMO is not feeding her baby. This baby is over 9 weeks old, but only weighs 8 ounces above her birth weight! Now I know every baby is different and grows at a different weight. Plus, I know breastfed babies grow healthier and leaner than formula fed ones, but really—only 8 ounces in over nine weeks?? That is less than an ounce a week whereas the normally fed baby gains 4-6 ounces a week. Plus, breastfed ones normally gain faster than formula ones in the first few weeks! Now this baby weight problem didn’t just come out of the blue. I distinctly remember at the 1 week visit seeing a baby who had not regained birth weight, and was left to cry in the pack-n-play while we just stared. We asked if we could console her baby, but the mom said no just leave her—ummmm. Seriously—red flags!
I’m sure there were visits in between, but, at a 6 week visit, my preceptor and I discussed what if this baby had not reached 10 pounds then we would have to have a serious conversation with the mother about supplementing or what is wrong. Well, we went into the visit and the baby had not gained anything and we didn’t really discuss in a serious way, IMO, the situation. So, we essentially discharged her from our care because baby seemed to be alert, active, and reaching milestones. While yes, those are signs of a healthy baby and I will eat my words if nothing comes of this troubled relationship, but I don’t understand why we are not intervening or haven’t intervened more yet. Yes, maybe it is just me and my insecurities that all will not be okay if I just let it be, but since the baby’s pedi and another midwife have been dragged into this family’s care, since they saw obvious flags too, I am uneasy with being so blasé with this issue.
If I was the primary care giver, I would be writing a letter to all involved saying where I stand and what my professional opinion is on this. So, tonight’s visit was to drop off a baby scale for the mom to weigh the baby at least once a week and report back to another midwife. While this is great, the mom instantly seemed defensive on how the baby has already gained 2 ounces this week—ummm, again, that is a diaper change, lady!! She went on to say how her other daughter was small like this and she was as a baby. Ok, yes genetics play a huge part—I will agree with her, but most moms who are having weight gain issues will be begging you to try and help them get the baby to up to weight regardless of her wishes to exclusively breastfeed. So, the baby woke up form a nap and mom said, well she is probably hungry, but I am not feeding her for another 2 hours because we are on a 4 hour feeding schedule per pedi suggestion that she was breastfeeding too often and the baby was not getting enough hind milk. Ok, so your pedi must have said that she needed to supplement with something in the meantime—right? IDK of any pedi who suggests an underweight baby be fed every 4 hours. HMMMMM. Ok, well I just read an article a few weeks ago about how that whole hind milk/foremilk separation issue was a bunch of hooey. While yes, more hind milk is at the need of a feeding, it still is in the beginning too. So baby sucked vigorously on her hand while we were there. I asked if she was doing the nipple sandwich and massaging the breast while breastfeeding and she said she used to. She said also that sometimes she pumps after feedings and gets about 2 ounces to feed to baby with a spoon or syringe since she doesn’t want to confuse the baby with a false nipple—well, hello I don’t care if the whole neighborhood takes turns breastfeeding your baby—you have to feed it something! At this point, nipple confusion is the least of our concerns, lady! Ok, moving on—she says that mother’s milk tea does wonders for her and she instantly feels like she has oodles of milk. Another really comes to mind—I have known many, many, many breastfeeding mothers and can I honestly say that I know none who have benefitted tremendously from that tea unless they were downing gallons of it. While yes, I have seen great results on Fenugreek and Blessed Thistle or Reglan and Domperidone, but MMT? Nope, not buying it. She wasn’t supplementing with any other medications yet either. And what about baby’s sleeping patterns? Oh yes, she falls asleep on her own usually sucking her hand and sleeps all night. WOW. So many 9 week old babies are doing that—not! If the baby is not growing, she should be breastfeeding around the clock with no stretch longer than 5 hours. I have a feeling that her Ferberizing method is backfiring in her face and that is what is going on. I am really getting sick of these crazies who want to schedule feed their babies. Seriously ppl! And it is so hard not to compare these babies with ones of similar age who are doing well. If I could do tonight over again, I would have asked her how much the baby is going to the bathroom—not that that is always an indication of baby’s well-being or if the mom changes diapers as often as I would, then amount of wet and dirty diapers may not be accurate.
My Journey as a Licensed Midwife in Louisiana 