Textbook Problem

Breastfeeding and Adequate Nourishment

Molly G. is a 24-year-old office manager and part-time aerobics instructor who has delivered vaginally, without complications, a healthy, full-term son, Daniel. With a birth-weight of 3200 g (7 lb), Daniel is the first child for Molly and her husband. Molly is 162 cm (5 ft 4 in.) tall with a prepregnancy weight of 56.8 kg (125 lb). She gained 25 kg (55 lb) during her uncomplicated pregnancy and has been a lacto-ovo vegetarian for five years. After a 12-hour stay in a birthing center, Molly and her husband bring Daniel home.

At four days postpartum, Molly, her husband, and her mother-in-law bring the baby to the health care center for his first follow-up visit. Molly and her husband are very concerned about whether their son is getting adequate nourishment, so the dietitian is called to see the family. During nutrition assessment, the following information is documented. Daniel weighs 3,000 g (6 lb 6 oz). The parents report that Daniel nurses vigorously about every 1½ to 2 hours and never sleeps for more than a couple of hours. Molly says that her milk “came in” on the second postpartum day and that she feels like all she does is nurse. Her nipples are tender, but not uncomfortably sore. She reports that Daniel has at least six to eight wet diapers and two to three very loose stools each day. She wonders if she has enough milk and worries about how she will ever return to work in two months. She also wants to lose the excess weight she gained during the pregnancy and is eager to return to her aerobics classes. Her husband and mother-in-law are supportive, but they worry about the baby.

The dietitian’s nutrition assessment of the infant concludes that Daniel is a healthy infant with no nutritional problems. The family is referred to their pediatrician for further follow-up.

Questions

If Molly lived in your community, what resources would be available for help and support for breastfeeding mothers?