I apologize if this was already said, we have had computer problems on 
and off these last weeks. For the babies that seem to do ok for the 
first 6-8 weeks at the breast, but later fall off the charts: I look at 
oral motor issues. Test weights show how much baby is removing at each 
feeding. Often mom needs to do 24 hour test weights to get an accurate 
daily intake assessment. Sometimes these babies do ok in the first weeks 
because they are riding mom's abundant milk supply and let down but as 
things down regulate due to lack of appropriate sucking stimulation, the 
baby begins to not gain weight correctly anymore. Evaluation by a good 
SLP or OT is helpful. I have worked with several older babies who had 
this pattern. Some start to do better with an SNS device. Some never 
recover and end up bottle fed. Many moms can not increase their milk 
supply enough for 100% BF at this late date but it is worth trying. My 
second thought is that many mothers schedule their baby's feedings or do 
not nurse enough times during the day. I get a lot of calls from moms 
with "low milk supply" or non-gaining older babies and they are only 
nursing 5 times in 24 hours. This isn't the case from what you said, but 
is something to consider with other mothers.

Kathy Eng, BSW, IBCLC

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