By Dr Lane Robson
Today the most worrisome child was the last child. Grandma brought in a 7-day-old infant. The Mom was in the next room with an OB GYN Physician Assistant from San Jose, who helps out at the clinic several times a year.
Grandma reported that the tummy of the baby felt hollow when she tapped on the abdomen. She advised that the baby had not gained weight in the first week, which is not unusual, but the baby looked tiny and tired. Grandma could not answer all the questions and so I waited until Mom was available. When Mom walked in she was about 15 years of age. This was her first baby, and she was floundering with breastfeeding. She explained that the baby only fed twice during the daytime, or about every 6 hours, and was otherwise asleep, and then she fed every hour or two over night. The baby only fed about two minutes at a time. Babies need to feed often or their blood sugar falls, which can lead to tiredness and worse. I asked Mom to show me how she breastfed and then we reviewed the importance of latch and good positions. I asked Mom to show me how she burped the baby and I corrected her approach. I explained the basics of the frequency and duration of breastfeeding to Mom and Grandma. We arranged for the baby and Mom to be reassessed and weighed in a week at Las Salinas. This baby is a very high risk for failure to thrive.
I saw two infants who were brought in for well baby checks by their pregnant Moms. The Moms were at the clinic to see the OB GYN Physician Assistant. One baby was 4 months old and the other was 5 months old. These Mothers were pregnant within several months of delivery and they will deliver two babies in less than a year! Ouch! I’m glad the OB GYN Physician Assistant is available to help them with birth control.
Today was mostly a well child check up clinic. There were some coughs and colds. We saw 13 children including one follow up.
Lane Robson, MD, is medical director at the Children's Clinic in Calgary, Canada.
DISCLAIMER: This blog was originally posted on January 5, 2012 at http://helpnicaraguachildren.blogspot.com/2012/01/. Please note, Dr Robson is not accepting donations at this time. However, he would greatly appreciate your comments and suggestions in support of his efforts.
