>I have been consulting a 30 year old first time mother, with a 13 
>week old baby boy, who has a consistent low supply.
>She has given me permission to post (PTP) to see if we can find an answer.
>Mother desparately want to continue to feed baby, and also next 
>child, however is now having to supplement due to constant weight 
>loss in child.


Rebecca, can you share the precise weight gain/loss of this baby?

He must have gained weight, to weigh 6 kg at 13 weeks from a 
birthweight of 3900 kg which is just over the 75th centile. He has 
dropped one centile line, which in the UK is regarded as well within 
normal limits.  If he is actively and constantly losing weight at 
this stage, I agree this is cause for concern, but if his weight gain 
has just been too slow to maintain the 75th centile then this of 
itself is not a concern.

Having said that, it is very possible she has not been able to make 
sufficient milk for him - supplementing at 3 days old is rarely 
necessary because if the baby needs more than he can actively get at 
the breast direct the mother should be encouraged to express 
colostrum. Any maternity unit ordering supplementing with formula at 
3 days without working on improving intake direct or with ebm is 
usually a maternity unit which has done other things to undermine 
early bf (mother-baby separation, no skin-to-skin, scheduled feeds 
and so on).

If the mother is under-producing (which she almost certainly is by 
now, if she has continued with formula all this time) then the 
reasons are (from what you say) entirely iatrogenic. The usual 
methods will fix this - breastfeeding direct, day and night, ad lib, 
with a careful reduction of the amount of formula given.

I would suggest she has been over-managed - the 5-day clinic stay, 
the test weights, the SNS, the fenugreek, the motilium....phew!

Heather Welford Neil
NCT bfc, tutor, UK
-- 
http://www.heatherwelford.co.uk

http://heatherwelford.posterous.com

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