care plan for newborn

[nahri83]

Hello all. I am a first time user and was hoping to get some help on a care plan for a newborn, not the mom. The issue that I want to address has to do with the baby's weight. I know that it is normal for babies to lose up to 10% of their birth weight but for this baby, she lost 10.3% on the first day, 11.5% second day and 11.6% third day. Mom is breast feeding about 15-20 mins on each breast every 2-3 hours. Her doctor recommended that she use formula to supplement but the mom refuses. Any suggestion?

Thank you!

[earthcrosser]

To clarify, has the baby lost a third of their total body weight or just 11.6% over the course of three days? My brain may be not quite getting what you meant...plus, if the baby lost a third of their body weight in three days, I'm not sure why nothing else was done other than tell the mom to supplement. I'm assuming it's 11.6% total then...

Teaching mom about importance of nutrition is essential, but mom may only be getting tiny amounts of milk right now. There are many questions and details you can think about that will help shape a good care plan in regards to this.

Was the baby a section? Is this mom's first baby/first time breastfeeding? How is the baby's output? Is the baby feeding for more than 30 minutes at a time? Does mom feel that the baby is latching and sucking well? Has mom tried expressing milk after feeding the baby and using EBM to supplement breastfeeding on subsequent feeds?

You need to think about what you would look for on the baby to assess for good nutrition and fluid intake, as well as really identify what your diagnosis would be for the situation. It's harder to do a care plan if your diagnosis and goals aren't solid.

[CrunchyMama, ASN, RN]

Glad she didn't listen to the Dr! Ahhhhh! Anyway....it sometimes takes a good 3 days, if not more for a moms milk to come in. Totally normal! I would encourage mom to feed on demand, unless the 2-3 hours is already on demand. Nursing often will help the milk come in quicker and help establish a good supply. If the baby is having 6-10 wet/dirty diapers in a 24 hour period, he/she is fine. The most important thing is to just nurse nurse nurse! Also...avoid pacifiers and other artificial nipples. Baby should be sucking on mom and that's it. Not only does this prevent nipple confusion but stimulates milk production.