I wonder if her supply at night is lower than it is during the day. If she only gets 8 oz in 8 hours she is making about an ounce an hour during the daytime. Many moms I work with find their production is lower at night...so this baby might be getting only about 20 oz or less in 24 hours. You also mention that the mom had a freezer stash. When moms with marginal supplies start tucking milk away for a later date, I often see weight gain in the infant decrease. These babies need every drop the mom is making and yet some if it is going into the freezer. Combine that with the fact that when her baby wasn't gaining well she increased her breastfeeding. Well right now she is stimulating her breasts 7 to 8 times a day...so what did she increase from? Sounds like there was an early prolonged period of understimulation.

I would encourage her to pump 3 times not 2 when she is at work and continue to feed the baby the five other times and get the weight checked on a digital scale weekly now that the freezer stash is gone. Until this baby is reliably weighed under her new regimen of giving everything she produces in 24 hours without 'stashing" anything and with increased trips to the breast, I don't think you can make any judgements. I would enquire about birth control pills and consider galactogogues esp Domperidone. If her first was in the 95th percentile then her body is capable of making lots of milk - ideal circumstances for Dom.

Kathy Lilleskov RN IBCLC

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