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Thread: help, I'm really worried...dehydration?

  1. #11
    Join Date
    Jul 2007
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    20

    Default Re: help, I'm really worried...dehydration?

    Good morning all!

    We called the pedi. last evening and he suggested formula...we took her to visit a friend and midwife who said she was fine. She (the midwife friend) did weigh her though and she is now 6 pounds 3 ounces and she was born at 6 pounds 15 ounces. This is significantly more loss than the doc wanted to see, so that worries me (more that he will want to take drastic measures than anything else). He asked that I call when they open this morning and make an appointment for today to get a weight check and also to meet with the lactation consultant on staff there.
    I called the ONE privately practicing IBCLC last night and she suggested I bring the baby to the hospital b/c it had been too long since her last diaper and she needed IV fluids. WHAT????There are other IBCLC's but she was the only one available to talk to on the 4th. I will try to find/call someone else today.

    In better news:
    we had a very wet and very poopy (still that mix of meconium and yellow poop) last night around midnight.

    We had a wet diaper this morning around 3am
    and we had a second poopy diaper this morning around 6

    this is good, yes???????????????

    I couldn't bring myself to give her more than a few CCs of the formula last night b/c I was pumping so much more myself...I was getting about 6 CCs at a time yesterday and now I"m getting 10-13, so my gut says to stick with this for a while and see what happens. I know the pedi. will want me to super-supliment when I get there...but my heart and soul feel so much better now. Thanks everyone!

  2. #12
    Join Date
    Jan 2006
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    18,063

    Default Re: help, I'm really worried...dehydration?

    did you check out that video clip?
    scales can be wrong. Did you have an iv at birth?
    That can sometimes cause the baby to loose more weight after birth then they normal would have.
    Do you think that baby has a week suck or isn't nurseing well?
    that would be a good reason to get good help! giving the formula or breastmilk suppliment might just be a temporary thing!

    http://www.lalecheleague.org/FAQ/enough.html

    heres another good link form kelly moms
    http://www.kellymom.com/bf/supply/en...ml#supplements

  3. #13
    Join Date
    Sep 2006
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    562

    Default Re: help, I'm really worried...dehydration?

    Quote Originally Posted by ice_queen View Post
    we had a very wet and very poopy (still that mix of meconium and yellow poop) last night around midnight.

    We had a wet diaper this morning around 3am
    and we had a second poopy diaper this morning around 6

    this is good, yes???????????????
    Yes, this is VERY good. It suggests that the pumping and EBM supplements are doing the trick to keep her hydrated, which is our first and most vital concern. Keep tracking those diapers until further notice, okay? Remember -- at least 6 good wets and 2-3 quarter-sized poops in every 24-hour period. That's the minimum to be sure that she is getting enough milk. So starting with that very-wet-very-poopy dipe around midnight, we want to see at least 3-4 more good wet diapers between now and midnight tonight.

    We called the pedi. last evening and he suggested formula...we took her to visit a friend and midwife who said she was fine. She (the midwife friend) did weigh her though and she is now 6 pounds 3 ounces and she was born at 6 pounds 15 ounces. This is significantly more loss than the doc wanted to see, so that worries me (more that he will want to take drastic measures than anything else). He asked that I call when they open this morning and make an appointment for today to get a weight check and also to meet with the lactation consultant on staff there.
    Twelve ounces is a shade more than the 10% max initial weight loss that is considered normal. This is consistent with the theory that she wasn't making diapers because she wasn't getting enough milk by just nursing. Of course, we should also consider that your midwife friend was presumably not using the exact same scale that your LO was last weighed on. That can introduce a bit more margin of error in the measurement. Weight checks should ALWAYS be considered as just one piece of information, not the end-all-be-all of a baby's well-being.

    It's wonderful that your ped has a lactation consultant on staff and available to meet with you right away! Ask if she is an IBCLC. Ask her to help you evaluate your daughter's suck and milk transfer.

    I called the ONE privately practicing IBCLC last night and she suggested I bring the baby to the hospital b/c it had been too long since her last diaper and she needed IV fluids. WHAT????There are other IBCLC's but she was the only one available to talk to on the 4th. I will try to find/call someone else today.
    I'm sure it was upsetting to hear that. Keep in mind that this IBCLC was going by your holiday-night phone call and had not seen your daughter. This also presumably happened before the midnight very-wet-very-poopy diaper.

    Both that IBCLC's and your ped's reactions should underscore how potentially serious it is when a newborn's diaper count is low. I doubt they are out to sabotage your breastfeeding relationship. The fact that the ped keeps a lactation consultant on staff and encouraged you to meet with her right away suggests that he does take breastfeeding seriously as an integral part of his practice.

    I couldn't bring myself to give her more than a few CCs of the formula last night b/c I was pumping so much more myself...I was getting about 6 CCs at a time yesterday and now I"m getting 10-13, so my gut says to stick with this for a while and see what happens.
    More output at the pump is a great sign -- suggests that your milk is coming in. You are more than 5 days postpartum now, so we definitely want to see your milk increasing in quantity and changing to the thinner mature milk. Keep pumping until we know that your daughter can adequately drain your breasts to stimulate your milk production all by herself.

    I know the pedi. will want me to super-supliment when I get there...
    Maybe, maybe not. And your doctor will advise you on what he feels is the best course of action. He won't force-feed your daughter against your wishes. Meet with the lactation consultant and see what she observes and what she then suggests.

    but my heart and soul feel so much better now. Thanks everyone!
    I'm glad to hear it -- this must have been a very frightening few days for you! Keep up the good work on nursing, pumping, and syringe-feeding your EBM. I will be very interested to hear how things go when an IBCLC evaluates your daughter's latch, suck, and milk transfer.

  4. #14
    Join Date
    Dec 2005
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    3,900

    Default Re: help, I'm really worried...dehydration?

    Welcome, ice_queen!

    Quote Originally Posted by ice_queen View Post
    SO - since I posted last she has not gone more than 1.5 hours without breastfeeding (in waking hours...2 hours at night) without breastfeeding. She has had 3 LONG nursing sessions (more than 15 minutes)...but mostly short little stints of a few minutes here and there. I have been pumping out the colostrum between once and twice and hour, and since 8 am today she has had 23 MLs of pumped colostrum.
    How often is your baby feeding now? How often does she have a LONG nursing session? Can you see your baby swallowing? When she nurses, does she suck vigorously?

    Are your nipples sore at all?


    Quote Originally Posted by ice_queen View Post
    The local on-call person suggested that I try this method before resorting to suplementing...do you agree, or do you think I'm doing her damage by doing it this way?
    Supplementing with your own milk is optimal. However, if baby is still not producing enough wet and poopy diapers with this method, your IBCLC and/or doctor may suggest temporarily adding a little supplement.

    Quote Originally Posted by ice_queen View Post
    He asked that I call when they open this morning and make an appointment for today to get a weight check and also to meet with the lactation consultant on staff there.
    That's great! If there is any problem with baby's latch/suck the IBCLC will be able to pick up on it. Please report back and let us know how it goes!


    Quote Originally Posted by ice_queen View Post
    we had a very wet and very poopy (still that mix of meconium and yellow poop) last night around midnight.

    We had a wet diaper this morning around 3am
    and we had a second poopy diaper this morning around 6

    this is good, yes???????????????
    Yay! Much better.

    Today you want to see at LEAST six wets. To know what a really wet feels like (hard to tell in today's disposables, and some of the newer style cloth) take three tablespoons of water and pour it into a dry diaper. Feel that weight. You can even put this diaper in a plastic ziplock and sit it next to your diaper changing area for comparison with baby's next wet diaper.

    Quote Originally Posted by ice_queen View Post
    I couldn't bring myself to give her more than a few CCs of the formula last night b/c I was pumping so much more myself...I was getting about 6 CCs at a time yesterday and now I"m getting 10-13, so my gut says to stick with this for a while and see what happens. I know the pedi. will want me to super-supliment when I get there...but my heart and soul feel so much better now. Thanks everyone!
    You can help your baby take in more milk by aiming for 10 really good nursing sessions per day (breast compressions to keep baby actively sucking), pumping as much as possible, and hand expressing in additon to pumping. Supplementing with your own milk is optimal, and often quite easy. After feedings, you can even hand express onto a spoon and immediately feed this to baby. That being said, please know that judiciously using a formula supplement can be a good thing when it is used as a tool that promotes your breastfeeding relationship.

    It's WONDERFUL that you're seeing an increase in your pumping yeild and more importantly, your baby's diapers! Your production levels are increasing!

    Are you taking care of you? Are you resting? Eating well? Drinking to thirst (you're getting enough if your urine is pale)? Let everyone else take care of YOU, and you take care of the baby.

    More questions:

    What kind of pump are you using? How frequently are you pumping after nursing?

    Are you currently hand expressing any in addition to pumping?

    Have you been using breast compressions while nursing? Does this seem to keep your baby interested in nursing?

  5. #15
    Join Date
    Jul 2007
    Posts
    20

    Default Re: help, I'm really worried...dehydration?

    Hey everyone...an update:

    Went to the pedi and met with the lactation consultant...it was so nice! Turns out my milk was just starting to come in pretty good yesterday. She worked with us for almost an hour and a half. Apparently my daughter has a great latch and suck...she just alternates between being lazy and sleepy or being really MAD that she's not getting enough fast enough, so she gives up!

    She gave us a nipple shield, some plastic things to wear around my nipples, and SES (is that what the tube thing is called)...and directions to feed her every 2-3 hours (unless she shows signs of wanting it other times)...she thinks we were trying too often and therefore never catching her hungry.

    I pumped twice last night and got an entire ounce each time!!!!!!!!! This AM I got about 20-25 CCs. I'm so excited. If I can continue that kind of output, the formula will be seriously limited. YAY!

    Now we are just trying to get her to figure out how to nurse effectively without getting mad or falling asleep. oh and FYI, she had 5 poopy diapers and 3 wet ones yesterday...nurse was perfectly happy with that. YAY AGAIN!

    Anyway, i know it's still going to be a struggle especially as now I think she is growing accustomed to the SES and wants the milk to pour into her and it's not doing that...I"m a bit worried about her becoming dependent on these devices...but, I also feel complete hope that it will all be OK...and I wasn't really feeling that before, so that's GREAT.

    Thanks again SO MUCH for all your loving support. I really appreciate it

  6. #16
    Join Date
    Jan 2006
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    18,063

    Default Re: help, I'm really worried...dehydration?

    yeah I'm gald things are looking up and baby is getting some milk!

  7. #17
    Join Date
    Sep 2006
    Posts
    562

    Default Re: help, I'm really worried...dehydration?

    This is all fantastic news ... I'm SO glad that your session with the lactation consultant was really helpful as well as affirming. It sounds like you and your daughter have definitely turned the corner on those early difficulties. Again, you are to be congratulated for being willing and knowledgeable enough to reach out and find skilled lactation support as soon as things got complicated.

    You are concerned that your LO is coming to prefer the faster flow of milk from the supplemental nursing system (SNS):

    Quote Originally Posted by ice_queen View Post
    Anyway, i know it's still going to be a struggle especially as now I think she is growing accustomed to the SES and wants the milk to pour into her and it's not doing that...I"m a bit worried about her becoming dependent on these devices...
    In time, you can work to "wean" her off of the SNS. For now, use it as appropriate to support the establishment of your breastfeeding relationship ... but when things are more solid with your milk supply etc., you may be able to gradually and patiently teach your daughter to work a bit harder and be a bit more patient for her milk. Here is a story about how one mother used an SNS successfully and then later stopped using it.

    It is really kind of you to come back here to share your happy update. We love to hear success stories! Don't hesitate to post again with any questions or concerns.

  8. #18
    Join Date
    Jul 2007
    Posts
    20

    Default Re: help, I'm really worried...dehydration?

    another update:

    She is still getting really mad at the breast about half of the time...I"m still a bit concerned about her latch and whether it is actually good enough to get any thing out...but we are supplimenting when she doesn't nurse for a good 7-10 minutes on each side...the great news here is: I"m not making and pumping enough milk that I have been able to supplement with MY OWN MILK...no formula since Thursday (and even then she only got a few ounces actually). I am so thrilled about this, it makes it all seem possible!

    She is still not having very many wet or poopy diapers (only 2 of each yesterday)...but the nurse wasn't too concerned because she is only taking about an ounce of supplementation at a time (she will take more later I guess...but her tummy isn't ready for it right now as she went so many days without it). She said that if we are getting 4 poopy OR wet diapers a day we are probably fine...so we are going to go with that right now. When she hasn't had a wet in several hours, we are supplementing regardless of how much she nurses...this is the plan for now. If I have learned anything from mothering thus far it is to not expect the plan to happen the way you plan it...flexibility has taken on a new meaning for me!!!

    Yesterday she was ALERT far more than she was asleep...and I was able to nurse her pretty consistantly when she was awake and alert...today so far she has had about even awake/asleep times...we are trying really hard to pay attention for the "nursey face" and feed her then as this is when she doesn't get mad and impatient.

    Anyway, thanks so much for all your help!

    off to read the article about the SNS!

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