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jaundice

"You keep using that word. I do not think it means what you think it means."

6th April 2012 by Jax Blunt 28 Comments

No, not inconceivable. (Though go to the top of the class for recognising the Princess Bride quote. Bonus point if you know which character says it ๐Ÿ˜‰ )

In this case, the word is Average. It gets bandied about lots. In discussion of children’s school achievement. Talking about pay scales. It is so often abused in the news. And this week, I’ve allowed health professionals to beat me with it as though it were a stick.

Average weight gain for a breastfed baby is 30g (or 1 oz – which isn’t the same even though she used them interchangeably) proclaimed the doctor on Tuesday night. So we need to weigh him on Thursday and see that he’s putting weight on, 60 g. Put aside for the moment that their scales weren’t that accurate and let’s think about what this means.

This means that they are expecting the average weight gain to occur every day for two days. Even though the baby they are looking at isn’t average to start off with – he’s small. Even though average does not imply in any way, shape or form, daily. Instead what this means is that if you measure a sample of babies over a period of time, add the weight gains up, divide by the number of babies and the length of time, that’s where the 30g comes from. (I assume. There are other ways you could get to it I suppose, but that seems like a sensible approach to me. Actually I went searching. Kellymom has a different set of measurements that seem much more appropriate and reached in a very sensible way)

What it doesn’t mean is that all babies will achieve this every day. In fact, it’s pretty much guaranteed that very few of them will. Kind of like if you look for an average height 12 year old in a class of them, you won’t necessarily find any child of that height. (My own 12 year old is the height of an average 14 year old. Intriguing, eh? And she was a slightly small baby.) So what was I thinking when I agreed with the doctor yesterday that there should be a weight gain of around 200 grams by next Friday?

I was thinking that a highly trained professional ought to know what he was talking about. I was thinking that he is supposed to be there to first do no harm. Not that he was ticking boxes, causing stress (which works against breastfeeding and indeed good parenting), and had absolutely no good reason to suggest that 200g was a reasonable weight gain for this child, this week.

Now, it’s entirely possible that he could gain that weight. He’s done more than that before. But it’s also entirely possible that while being healthy and well fed he won’t achieve the bizarre target of the average. And at that point, if all is well, if he’s alert, happy, growing, and still filling nappies with gay abandon (which trust me, he’s doing at the moment) I hope you will all remind me to tell any nosey parker unsupportive health professional to take a running jump.

Average indeed.

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Filed Under: It's where it is Tagged With: breastfeeding, idiocy, jaundice

We're here again – hospital adventure part two.

5th April 2012 by Jax Blunt 17 Comments

10.38. Today’s nurse didn’t seem to care whether we ended up sitting with a bunch of possibly infectious children til I pointed it out, so now we’re in a room at least. No cot, so again I’m pleased I brought the car seat in. We’re on the appt board today, name spelt wrong obviously, so at least there appears to be a plan. Not that anyone is carrying it out.

This place just seems to be disorganised, without anyone having a real clue what is going on.

10.50 nurse came to weigh him, and took us to scales that only display one decimal point. Pointed out that they won’t even show up the weight gain the doctor is looking for and then dissolved in tears, about not knowing what is going on, and the doctor saying giving up breastfeeding and just everything. Returned extremely promptly to my room without weighing him and nurse gone in search of a doctor to explain what is happening.

11.05 We finally see a doctor. Who seemed completely uninterested in seeing Tigerboy, and was very much there to see me. Apparently all the blood test results were back and absolutely normal, so it’s felt he has breastmilk jaundice. I quoted a figure of 10% of breastfed babies still being jaundiced at 1 month, doctor didn’t know ๐Ÿ™ What he was concerned about was the slow weight gain – both doctors appeared to be convinced that breastfed babies put on a steady 30g (or 1 oz – which is it then??) a day, which is not my understanding of how it works at all. At this stage I pointed out (again, having already mentioned it to the nurse) that the scales they are using don’t go that accurate. He didn’t seem to know anything about that, saying that as long as his weight hadn’t dropped he was happy for us to go home and continue with feeding.

Lots of questions about feeding, again the suggestion that I express so that I can see what he’s getting. It disturbs me that so many health professionals seem to know so little about feeding and the mechanics of it that they recommend expressing as a first response instead of recommending that you see an expert who can evaluate the feeding.

Nevertheless we did the weighing (heartstopping moment when the scale looked to be reading 3.5 which would have been a loss, then it went back to 3.6. Phew.) and then we were cleared to go home.

11.44 after a feed (obviously) going home.

This whole experience has been demoralising and stressful. The doctor I saw on Tues night seemed to be implying there was a high risk of something seriously wrong – today’s just as obviously knew all was fine. Which made me very cross that he’d left me worrying, and dragged me up to the hospital just to weigh Tigerboy on scales not suitable for the purpose, costing me fuel, parking and time, meaning we missed Smallest’s swimming lesson too. Not to mention the NHS time and resources that were wasted.

Obviously if there’d been a need for us to see a doctor I’d have been very happy to go up there, but there really wasn’t. And I should have been focussing on feeding instead of being undermined and carting car seats around hospitals.

I will be making a complaint. I’ll put it up here too.

And thank you so much for all your support. Here, elsewhere, twitter and texts – you’ve been my lifeline.

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Filed Under: breastfeeding, It's where it is, tigerboy Tagged With: breastfeeding, jaundice, NHS

Crisis of confidence.

3rd April 2012 by Jax Blunt 9 Comments

Tell me I’m doing it right?

Tigerboy is feeding on demand. Sometimes it feels like he’s feeding round the clock. I do sometimes distract him – pop him in the wrap and go out for a walk for example, but mainly when he wants food he gets it.

He made his birth weight back in 5 days, and put on nearly 9 oz in the next week. However since then he’s only put on another 6 oz, making a pound gain since birth. And the jaundice, which disappeared entirely after a day in a sunny conservatory is today back with a vengeance. So today’s health visitor, after dispensing the third oral vitamin k dose, made us a hospital appt for this afternoon.

Aaargh. Tigerboy seems determined to do things differently. First early baby. First yellow baby. And now first baby with hospital referral. Tell me it’s all ok?

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Filed Under: tigerboy Tagged With: breastfeeding, jaundice

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