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Thread: concerned grandma

  1. #1
    Join Date
    Feb 2007
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    Default concerned grandma

    Hi - I have a 1 wk old grandson whose dedicated mom is breastfeeding. The baby has lost about a pound (7/15 at birth) - he did seem a little dehydrated when I saw him last - Monday. Mom went to a lactation specialist yesterday who gave her some vitamins (I don't know what) and a contraption with a tube to supplement. My only real question is - if the lactation lady had been concerned with the health of the baby, she surely would have sent them to a doctor - right? I have gotten a lot from reading the other postings - this is a great site. My daughter in law is working hard at being the best mom she can be - she is already! thank you -

  2. #2
    Join Date
    Jan 2006
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    Default Re: concerned grandma

    Weigh loss in the first two to three weeks of baby is very common. My daughter lost 1.5 Lb in the first two weeks, My son lost 1 pound. THat does not mean that moms supply is low.
    What I beliave the lactation consultant gave your DIL is a nurse supplementer (SNL). I would recommend her not to use this yet. She needs to nurse, nurse, nurse and nurse some more on babies demand. The first pediatrician appt is probably next week for your grandson. The doctor will determine then the progress on his weight. Until then tell her to nurse only, no water, no formula, no nursing supplementer.
    Congratulations grandma, and keep encouraging her! Any questions, we are here to help

  3. #3
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    Default Re: concerned grandma

    Do you know if the lactation consultant was IBCLC certified? If so, I would honestly do whatever she recommends. The standard accepted weight loss (from what I've been told) is about 10%. From my calculations, that would be 13 ounces. So, your grandson has lost more than 10%. I'm no expert, but it sounds like your daughter-in-law is doing her due diligence and asking for help. If she is still concerned, she can always go back to the doctor and have her little one weighed more often, just to see if baby is starting to gain.

    Lisa

  4. #4
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    Jun 2006
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    Default Re: concerned grandma

    I would say if she can get someone in there to help her with cleaning and chores...etc... she should "camp-out" and do nothing but nurse for the next week! Do you know his weight now? Did the LC want her to give the baby formula is the SNS?
    Last edited by Number3; February 14th, 2007 at 04:24 PM.
    Click here to find an LLL leader near you...or call 1 877 4 LA LECHE for help now.

    "No one can make you feel inferior without your consent."
    Eleanor Roosevelt


    "Do not go where the path may lead, go instead where there is no path and leave a trail."
    Emerson


    Ban the bags. ......... Watch your language. ....... Help keep Dr Newman's clinic open!

    We demand that our childcare providers are CPR certified... why don't we demand the same of ourselves! Get certified!

    I lost 22 lbs in 8 months... with a bit of determination and common sense information from this book.

  5. #5
    Join Date
    Sep 2006
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    562

    Default Re: concerned grandma

    Mary, welcome to the boards, and congrats on that new grandbaby! I'm glad your daughter-in-law is breastfeeding. Many new babies and mommas get off to a rocky start with breastfeeding, but with accurate information and the right kinds of support, nearly all of them do just fine.

    I am concerned about your grandson's weight loss, and also about the signs of dehydration you mentioned. Could you give us some more details? Best of all would be if your daughter-in-law herself could post, unless you are right there on the scene just being her hands to type posts.

    The general guideline is that if a newborn loses more than 10% of his birth weight after birth, that is a strong indicator that he needs more milk. Ten percent of 7 lbs. 15 oz. is about 12 ounces, so if he has lost a full pound, that's worrisome.

    We also like to see a baby start to gain weight around the time that his mother's milk "comes in" (changes from small amounts of colostrum to a greater quantity of mature breastmilk). This typically happens about 3 to 5 days after birth. If a one-week-old baby is still losing weight, then again, that is a strong indicator that he isn't getting enough milk.

    Diaper output is the absolute best indicator of milk intake -- what goes in, comes out! By one week in age, he should be making 5-6 good wet diapers (if they're disposables; about 8 if using cloth) in every 24-hour period. Also, in every 24-hour period, he should be making 2-3 poops that are at least an inch across (the size of a quarter) when you look at the dirty diaper.

    If his diaper output is MORE than this, that's great. But if it is BELOW this guideline, even just a little, then that's a strong sign that he is not getting enough milk.

    If there are concerns about the baby's milk intake, that doesn't necessarily mean the problem is a low milk supply. He may not be nursing effectively. We can't really diagnose the underlying cause of inadequate milk intake without asking a lot more questions, and as I mentioned above, it would be simpler and more reliable to communicate directly with your daughter-in-law if she is willing to post here.

    I also would encourage your daughter-in-law to call a local LLL Leader with her questions or concerns as well as following up with a credentialed IBCLC lactation consultant. It's not possible for us to know what the lactation specialist observed or what she said to your daughter-in-law, so I can't make a judgment about what that lactation specialist did for her yesterday. However, lactation consultants who have the IBCLC credential have done the most rigorous training and have LOTS of experience working with nursing babies and mommas. Without that credential, it's not possible to know what a lactation specialist's qualifications or skills are.

    I'm sure you are torn between wanting to help support and encourage your daughter-in-law and wanting to show her that you trust her judgment and respect her new status as a mother. That can be a tricky line to walk in some relationships. We will be very happy to communicate directly with your daughter-in-law if she posts here, and that way she would be hearing information and ideas from us instead of from you, if that is an issue at all.

  6. #6
    Join Date
    Feb 2007
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    4

    Default Re: concerned grandma

    Hi - I thought I replied but I guess it got lost somewhere! thank you all - I will try to remember what you all said that I want to reply to. The specialist first saw her in the hosital before they checked out - so I am assuming that she must have some credentials? When they met the other day, the specialist called the pediatrician to see if anything else should be done - he said no. They have another appointment today - will feed, weigh, etc. When we spoke yesterday she said that the baby is "having diapers" more, seems more content and seems to not be "using" the tube thing - I have not seen how that works, so I don't quite "get it." When I said that he seemed dehydrated, I mean that his mouth seemed dry to me - it didn't look like he had been drinking anything - and his skin seemed dry - but I guess all newborns seem kind of dry - ? Also - for what it's worth - I know that she was leaking, even spraying, milk - but she is very small breasted - they said that might have something to do with it all. She nurses pretty much on demand - seems to be getting into a routine where he is up, eats, "visits", and then sleeps - not nearly as much crying as before. She was hopeful yesterday that maybe she is producing more(from the vitamins they gave her?) I am very confident that she will follow through with whatever they tell her to do. Her mom is REALLY far away - we get along great, but you are right, I do not want to meddle! I did stay there with them for about 4 days - did all the household stuff to help - will go back when/if they need me - they are a pretty independent family! thank you again - further feedback appreciated . . .

  7. #7
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    Sep 2006
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    Default Re: concerned grandma

    Hi Mary, and thanks for your reply. It sounds as if your daughter-in-law is feeling more confident and is on the ball with follow-up visits to the lactation specialist and pediatrician.

    There is no requirement that hospitals employ IBCLCs as their lactation consultants, so the fact that she works at the hospital doesn't necessarily mean she is credentialed.

    A mother's breast size might influence how OFTEN the baby needs to nurse, but it will not have an impact on how much milk she can produce. The key to a good milk supply is to nurse frequently in the early days and weeks and to watch the baby, not the clock.

    The appearance of a baby's mouth or skin is not a reliable indicator of dehydration. Diaper output is your best guide -- at least 5-6 good wets and 2-3 dirties in every 24-hour period are the minimum at this age.

    If your daughter-in-law is the type to read books about this stuff, a good one for new mothers is Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers by Mohrbacher and Kendall-Tackett. If she seems to have questions or concerns, then please encourage her to contact LLL directly, whether locally or here on these boards (or both!)

    There are no vitamin supplements, to my knowledge, that will increase a milk supply. She may be taking particular herbs or using a prescription medication that does this. But herbs/meds alone won't do the trick; she also needs to be practicing good breastfeeding management (nursing on cue, letting the baby finish the first breast first, etc.) and the baby needs to be good at milking the breast.

    I'm sure your daughter-in-law appreciates all the help you have given them as well as the support and encouragement you can offer. Just keep building up her confidence and, where possible, gently steering her towards reliable information and resources.

  8. #8
    Join Date
    May 2006
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    Default Re: concerned grandma

    When we spoke yesterday she said that the baby is "having diapers" more, seems more content and seems to not be "using" the tube thing - I have not seen how that works, so I don't quite "get it."
    Maybe it would be a good idea to tell your daughter in law the number of diapers per day that indicate that baby is getting enough breastmilk...that LLL Rebecca quoted...5-6 wet disposables or 8 wet cloth diapers per 24 hour period with 2-3 poops at least the size of a quarter.


    When I said that he seemed dehydrated, I mean that his mouth seemed dry to me - it didn't look like he had been drinking anything - and his skin seemed dry - but I guess all newborns seem kind of dry - ?
    If you mean that the inside of his mouth was dry..that would be a sign of dehydration...but the skin, sometimes newborns lose a layer of skin after about a week or 2 from the change of being in liquid all the time to going to air. More signs of dehydration would be decreased wet diapers (less than the 5-6 good and wet disposables per day or 8 cloth diapers) or concentrated urine...dark in color.

    Also - for what it's worth - I know that she was leaking, even spraying, milk - but she is very small breasted - they said that might have something to do with it all.
    Being small breasted is generally just a myth. Even very small breasted women can fully breastfeed a baby...or babies for that matter. Size is NOT a good indicator of output....leaking and spraying is normal...especially in the first weeks after milk comes in.

    She nurses pretty much on demand - seems to be getting into a routine where he is up, eats, "visits", and then sleeps - not nearly as much crying as before. She was hopeful yesterday that maybe she is producing more(from the vitamins they gave her?)
    Breastfeeding is best when you ALWAYS nurse on demand. That's usually anywhere from 8-12 times per 24 hour period. Some babies nurse more often than others. At that stage, most babies need to nurse every 2 hours or so. And that's 2 hours from the start of the last nursing session, so if baby starts to nurse at 6 am then 2 hours would be 8 am. Its also normal for babies to nurse MORE OFTEN than every 2 hours...especially during growth spurts, its common for a baby to nurse every hour...hour and a half...or 2 hours. Its also normal for baby to go up to 3 hours...there is a variation among babies.

    I would also suggest that you encourage her to post on this forum herself. Its alot easier to answer a question directly from the person with the question.

    I would also encourage her to check out the main LLL website. There's alot of info there that would help her figure out if her supply is truly low, or if baby isn't latching correctly(baby wouldn't be taking in enough in that case, even though there's plenty available).
    Last edited by Mommie of 2; February 15th, 2007 at 01:23 PM. Reason: forgot a word...whole sentence didn't make sense

  9. #9
    Join Date
    Jun 2006
    Location
    Not around here as much :(
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    Default Re: concerned grandma

    I just want to jump in here and talk about the dry skin because thats all I can offer at this point

    My DS has dry skin. It feels dry and looks dry - not scaly dry but you can feel that is just not full of moisture. Its only in a few places and some of it is eczema. Thought its quite true newborn are famous for their certain spots of peely dry patches... I would aslo say this isn't a good indicator of dehydration. Good luck!

    Click here to find an LLL leader near you...or call 1 877 4 LA LECHE for help now.

    "No one can make you feel inferior without your consent."
    Eleanor Roosevelt


    "Do not go where the path may lead, go instead where there is no path and leave a trail."
    Emerson


    Ban the bags. ......... Watch your language. ....... Help keep Dr Newman's clinic open!

    We demand that our childcare providers are CPR certified... why don't we demand the same of ourselves! Get certified!

    I lost 22 lbs in 8 months... with a bit of determination and common sense information from this book.

  10. #10
    Join Date
    Oct 2006
    Posts
    177

    Default Re: concerned grandma

    I just wanted to say that I think it's awesome that you are finding out correct information before you help your daughter in law and that you are so encouraging and can see that she's a great mother and doing the best she can. Kudos to you! Unfortanately many grandparents don't stay up to date on information and just share what they thought to be true from their days as parents and are pushy about it. I can see how much you love your daugher in law and want to truly help her. Does she have a computer? Maybe you could direct her to this sight so she could also search for answers and ask questions.

    Also, just FYI, I have very small breasts and had zero trouble nursing. My dd has always been extremely healthy and actually big for her age. So small breasts are not a factor at all.

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