N7 · Baby feeding poorly
Actual Maternal and newborn
Definition
The baby has weak sucking, poor latch, or takes too little milk.- Poor latch
- sleepiness
- tongue-tie
- low milk
- illness
- Short feeds
- poor weight gain
- weak suck
- fussiness
📋 Scenario
A baby falls asleep early at feeds and loses weight.
Subjective (S): "He keeps falling asleep and won't feed."
Objective (O): Baby lost 9% of birth weight; weak suck; falls asleep; 3 wet diapers daily.
Assessment tools for this scenario: CP-MOTHER Mother & Newborn Check CP-SAFE Safety & Falls Score CP-FLUID Fluid Balance & Nutrition Score
Validated scales to consider: MEOWS, APGAR, Morse Fall Scale, MUST, fluid chart, glucose
**CarePath diagnosis:** Baby feeding poorly related to poor latch, as evidenced by short feeds and poor weight gain.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Check the latch. | A poor latch is a common cause of weak feeding, so checking it finds problems that can be fixed to help the baby take more milk. |
| Wake the baby. | Sleepy babies feed poorly, and waking him with gentle stimulation lets him feed long enough to take in needed milk. |
| Set a feeding plan. | A clear plan with feeding times gives structure so that he is fed often enough, since weight loss shows he is not getting enough now. |
| Weigh regularly. | Regular weights show whether feeding is working, and tracking them allows the plan to change if weight keeps falling. |
| Get lactation help. | Lactation specialists have extra skill in fixing latch and supply problems, which can be hard to correct without expert help. |
| Report problems. | Reporting problems promptly ensures that the doctor reviews him, because a loss of 9% of birth weight and few wet diapers may signal dehydration. |
**Expected outcomes**
- Feeds 8-12 times a day.
- Gains weight by day 7.
- At least 6 wet diapers per day.
**Linking the data to the diagnosis**
The baby falls asleep at feeds, and his mother says, "He keeps falling asleep and won't feed." He lost 9% of birth weight, has a weak suck and has only 3 wet diapers daily. This fits baby feeding poorly because intake is too low, shown by weight loss and few wet diapers, and the problem is already present, so it is actual. The plan aims for feeding 8 to 12 times a day, weight gain by day 7 and at least 6 wet diapers per day, by checking the latch, waking him, using a feeding plan and getting lactation help.
CarePath diagnosis
Baby feeding poorly related to poor latch, as evidenced by short feeds and poor weight gain.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Check the latch. | A poor latch is a common cause of weak feeding, so checking it finds problems that can be fixed to help the baby take more milk. |
| 2. Wake the baby. | Sleepy babies feed poorly, and waking him with gentle stimulation lets him feed long enough to take in needed milk. |
| 3. Set a feeding plan. | A clear plan with feeding times gives structure so that he is fed often enough, since weight loss shows he is not getting enough now. |
| 4. Weigh regularly. | Regular weights show whether feeding is working, and tracking them allows the plan to change if weight keeps falling. |
| 5. Get lactation help. | Lactation specialists have extra skill in fixing latch and supply problems, which can be hard to correct without expert help. |
| 6. Report problems. | Reporting problems promptly ensures that the doctor reviews him, because a loss of 9% of birth weight and few wet diapers may signal dehydration. |
Expected outcomes
- Feeds 8-12 times a day.
- Gains weight by day 7.
- At least 6 wet diapers per day.
Linking the data to the diagnosis
The baby falls asleep at feeds, and his mother says, "He keeps falling asleep and won't feed." He lost 9% of birth weight, has a weak suck and has only 3 wet diapers daily. This fits baby feeding poorly because intake is too low, shown by weight loss and few wet diapers, and the problem is already present, so it is actual. The plan aims for feeding 8 to 12 times a day, weight gain by day 7 and at least 6 wet diapers per day, by checking the latch, waking him, using a feeding plan and getting lactation help.