Commence formula feeding

When you bring Davina and her parents into the clinic room, she looks visibly bigger, with more fat on her cheeks and a healthier skin colour. Her parents do not look particularly happy.

Davina’s mother explains that when she started using formula milk, she clearly preferred feeding in this way and then became disinterested in breast feeding. Her breast milk then dried up and Davina now only takes bottled formula milk.

On the positive side, she has clearly grown well on the new milk and Davina’s dad is also able to feed her. Talking to her friends, she wonders if the problem with feeding was not simply a technical issue with how she was holding her baby and the latching on.

Now she brings up a little milk with each feed, and her parents wonder if this is caused by a milk intolerance. You explain to the parents that this is called ‘possetting’ and quite normal, but the parents look doubtful.

You re-examine her and there are no new findings. She has more subcutaneous tissue, especially on her abdomen.

Her weight is now 1.68 Kg and length 47.5 cm, head circumference 32.0 cm.

You plan to see her again in three months and then potentially discharge her from the neonatal follow up clinic. Her parents ask if this second appointment is really needed, although they will come again as requested.

In three months time you again welcome Davina and her parents back into the clinic room. Davina is now wearing a baby dress and looks very interested in the new surroundings.

Her parents are happy with her progress. She is smiling, recognizes her parents and beginning to try to use her hands.

As far as feeding goes, she is still fully formula fed. Her mother continues to regret that she is not able to breast feed but is pleased her daughter is obviously growing so well. Her posseting has stopped.

She is again measured - Weight 5.25 Kg, length 57 cm, head circumference 39.5 cm.

You are very pleased with her growth and her progress. You discharge her from the clinic, but leave the neonatal secretary’s contact details so that they can make another appointment if new problems develop.