A concern I have with some of the posts regarding not being concerned with 
slow or non-existent weight gain is that most of us are not doctors or 
nurses/midwives and are medically unable to evaluate a baby's physical 
health. Therefore we must be careful in telling a mother that everything is 
ok. Especially if we are doing phone help or consultations without test 
weighing.

The baby who is having many yellow BMs by day two without supplements (just 
breastfed) would be a different story than one who is has not had a BM in 24 
hours, sleepy, jaundiced looking etc. When one watches a baby nurse, if you 
see lots of active sucking in long repetitions of jaw movement with 
swallowing sounds, eyes opening up with the flow of milk, hands and arms 
relaxing as his tummy fill, along with plenty of BM diapers - this might be 
a baby one could wait a day or so and recheck the weight.

If  baby goes right to sleep on the breast, or does a few minutes of very 
short repetitions with no swallowing sounds and then falls asleep - one 
could surmise that little milk is being transferred (especially if diaper 
counts are poor and the weight is dropping). A sleepy baby who has stopped 
participating in feedings can not usually be trusted to "just breastfeed" on 
his own.

For those moms who are saying their baby's weight gain was very slow or 
non-existent for a while, I would have recommended test weighing over two 
days to see how much baby was taking in at each nursing.

Kathy Eng, BSW, IBCLC 

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