Cecilia is 3 months postpartum after a normal labor and full-term delivery. She

Question

Cecilia is 3 months postpartum after a normal labor and full-term delivery. She tells you that she is exclusively breastfeeding her baby about eight times a day but is very tired and is not getting much sleep because her baby always seems fussy between feedings—day and night. She has been determined to lose her “baby weight” and for the past 6 weeks, she has been restricting her caloric intake to around 1200 calories/day, including approximately six diet drinks every day. She reports that the pediatrician told her that the baby’s weight gain has slowed over the past month and she would like her to begin supplementing the baby with formula. She is hesitant to do this because her goal is to continue breastfeeding exclusively until the baby is 6 months old, and then possibly continue until at least the baby’s first birthday.

1- What would you tell Cecilia about losing her baby weight? (2)

2- How many calories and protein will Cecilia need each day (minimum)? Show your work (2) Why?

3- How does Cecilia know her baby is getting enough breast milk? (4)

4- What might help her baby’s fussiness and inadequate weight gain? (2)

5- Cecilia sometimes pumps her breast milk and freezes it, how long is it safe to store her breast milk in her home freezer? (2)

6- Cecilia want to take Milk Thistle because she has heard will help her milk supply, what can you tell her? (3)

7- What recommendations would you give Cecilia to maintain proper breast milk supply? (3)

8- Cecilia wants to know if she needs to clean her nipples before and after breastfeeding, what can you tell her? (2)

9- How long should Cecilia breastfeed her baby? Will her baby need supplements? When should solid foods be introduced and why? (5)

Explanation / Answer

1).

The weight gain of Cecilia’s baby was slowed in the past month because Cecilia reduced her daily calorie intake, which reduces the production of breast milk and also reduces the nutrients in it.

Cecilia must not try to lose the “baby weight” by calorie restriction, which is not a natural way to lose weight. She must take the daily calories as recommended for the postpartum women to ensure the availability of adequate nutrients to her baby. If she continues the same, the baby becomes malnourished and experience developmental delays. The baby must be provided with formula feed

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