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Preemie questions--formula suggested
Hello all,
My friend Kim had her third baby, Josie, 7 weeks early. Josie is now 6 weeks old. She is (was until last night) exclusively breastfed. Kim took her to the doctor yesterday for a weight check, and she had gained a pound in 2 weeks. Kim was really excited about that, as the doctor had told her that Josie should gain 1/2 to 1 ounce a day, and she ended up gaining more than that. But then the doctor was sort of pinching josie's skin and saying it was still kind of loose and that she should try to get her to gain more weight by giving her formula after every breastfeeding session. ! Kim says that Josie will nurse 5 or 10 minutes a side every 2 hours, fairly consistently throughout the day. She's tried this formula supplementation for the past day, and Josie has taken at most 1/2 an ounce at a time, and she gags at the bottle and just generally doesn't want to eat it. Kim called me just now wanting advice, because she just feels like it's stupid to try to force her to eat, especially when Josie gained more than they were hoping for. Plus, she's confused by why the doctor is even asking her to do this. She plans to call the doctor tomorrow. I don't know much about preemies, so I didn't have much to offer. I told her that I thought the supplementation might eventually lead to her having lower supply, which would be terrible because everything seems to be going fine. I told her if it were me I would not offer formula but would just try to breastfeed as much as josie would take. But then again, I don't know and Kim is just wanting to do the things that Josie needs her to do to grow. Kim did say she had a growth spurt last week, and her supply had caught up fine. Josie seems to be "emptying" her breasts at each feeding, in that they are soft after. Another thing, Josie has been sleeping a few 3 hour stretches today, after eating the formula, which to me means she's not getting as much breastmilk, which is not the way to help her gain weight in my opinion. I told her I'd ask here and see what advice was offered. Thanks for any help anyone can give, Lora |
#2
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Preemie questions--formula suggested
ack, it's a complete no brainer, no formula is needed at all, it would
be very very unlikely that the baby could gain such a good amount of weight yet be dehydrated, which I think must be what the skin pinching must be a test for, but it's not the primary sign, if baby is producing 6-8 wet nappies in a day then she's fine. With the skin thing, I don't think you'd expect a 6 week old 33 weeker to have the same features as a 6 week older full term baby, the kind of fat laid down in the last weeks of pregnancy are a different type of fat (called brown fat), I don't know exact details, but being on the outside and gaining that way, is going to be different to doing the same on the inside - I'm now expert on premies, but most weight charts have curves before the term line where you put plot premies and the line is curving slower than it is during the time after the birth - which implies that the expected weight gain would be less - this baby has met the upper range of what's expected for a term baby - this doctor is really way off to be saying supplement and that's very sad as the formula that has already been given will have changed the babies gut flora and it takes a month for that to return to how it was if she gives no further formula. The fact she takes half an ounce is definitely not an indicator she needs half an ounce, it's much more an indicator that she needs nothing as sucking when a bottle is inserted is a natural response. As a baby who is really only at 39 weeks gestation, she'd also be really vulnerable to developing problems due to having been given a bottle. Tell her to stop the formula now and get another doctor! Cheers Anne |
#3
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Preemie questions--formula suggested
On Jun 27, 7:47?pm, Lora R wrote:
Hello all, My friend Kim had her third baby, Josie, 7 weeks early. Josie is now 6 weeks old. She is (was until last night) exclusively breastfed. Kim took her to the doctor yesterday for a weight check, and she had gained a pound in 2 weeks. Kim was really excited about that, as the doctor had told her that Josie should gain 1/2 to 1 ounce a day, and she ended up gaining more than that. But then the doctor was sort of pinching josie's skin and saying it was still kind of loose and that she should try to get her to gain more weight by giving her formula after every breastfeeding session. ! Kim says that Josie will nurse 5 or 10 minutes a side every 2 hours, fairly consistently throughout the day. She's tried this formula supplementation for the past day, and Josie has taken at most 1/2 an ounce at a time, and she gags at the bottle and just generally doesn't want to eat it. Kim called me just now wanting advice, because she just feels like it's stupid to try to force her to eat, especially when Josie gained more than they were hoping for. Plus, she's confused by why the doctor is even asking her to do this. She plans to call the doctor tomorrow. I don't know much about preemies, so I didn't have much to offer. I told her that I thought the supplementation might eventually lead to her having lower supply, which would be terrible because everything seems to be going fine. I told her if it were me I would not offer formula but would just try to breastfeed as much as josie would take. But then again, I don't know and Kim is just wanting to do the things that Josie needs her to do to grow. Kim did say she had a growth spurt last week, and her supply had caught up fine. Josie seems to be "emptying" her breasts at each feeding, in that they are soft after. Another thing, Josie has been sleeping a few 3 hour stretches today, after eating the formula, which to me means she's not getting as much breastmilk, which is not the way to help her gain weight in my opinion. I told her I'd ask here and see what advice was offered. Thanks for any help anyone can give, Lora I would start by checking to see if the hospital where baby was born has a lactation consulting/breastfeeding education department. Our hospital offered this service free to mothers who delivered there for as long as they were needed. Unfortunately, a lot of pediatricians don't know as much about breastfeeding as they should and some feel better knowing what and how much baby is eating exactly for their own comfort levels. Here are a few links you can check out that may help. You may be able to find help through the LaLeche League as well. http://www.lalecheleague.org/NB/NBpremature.html and kellymom.com AOL also has some breastfeeding help boards where some women have dealt with breastfeeding premature infants. You need to remember that they, or at least most, are only parents and not medical professionals and that they can really only share advice they are familiar with and experiences they have had. I don't know how to get you to those boards though without AOL, but I'm sure you can eventually find it possibly going through aol.com. |
#4
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Preemie questions--formula suggested
Lora R wrote:
But then the doctor was sort of pinching josie's skin and saying it was still kind of loose and that she should try to get her to gain more weight by giving her formula after every breastfeeding session. ! This *may* mean that more breastfeeding is needed. Kim says that Josie will nurse 5 or 10 minutes a side every 2 hours, fairly consistently throughout the day. I would trust baby. Every 2 hours sounds like a great schedule at this age. I don't know much about preemies, so I didn't have much to offer. I told her that I thought the supplementation might eventually lead to her having lower supply, which would be terrible because everything seems to be going fine. This is correct. Every ounce that baby needs that the breast is not offering is an ounce that the breast is not producing, therefore leading to inadequate supply for baby. I told her I'd ask here and see what advice was offered. I think your suggestions to her are exactly correct. -- Anita -- |
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