Hi Sue,
Well, I mostly agree with Heather, that perhaps this baby does not need any additional supplement. 5th centile is normal (someone has to be on the small end of the bell curve). I would consider the 8% wt loss to not be unusual, but needing followup. I would consider 63 grams in 72 hrs to be a good gain. The only thing remaining is the lactation support. Did baby do this gaining strictly on expressed ebm, was baby given any formula at all during that time, is baby breastfeeding ad lib, but getting extra ebm? Mother's supply could suffer over time, depending on the answers to these questions. Does breastfeeding appear to be getting much better or not? I would expect that baby is getting better at breastfeeding, until he is A+ I would have mother continue expressing for "insurance" and feeding that to the baby. I would continue with weight checks maybe every 3 days until breastfeeding appears well established and baby is gaining on straight bf. If this baby has gained this amount on bf/ebm, then I would not recommend formula at all.
""Well term baby born on 5th centile. Weight loss 8% day five. Additional lactation management introduced-assessing latch and milk transfer, assessing out put, begin expressing and giving EBM. 72 hours later weight gain 63 gms-not met minimum 28gms per day. How much more EBM should this baby be supplemented with and if EBM not available how much formula should be given whilst continuing additional lactation support.""
Laurie Wheeler RN MN IBCLC, Mississippi USA
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