>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.


How about none? :)

After the further 3 days the weight loss has ceased - good. Could it 
not be that this baby is  doing just fine and simply needs to be held 
skin, breastfeeding ad lib day and night, with someone unobtrusive 
and knowledgable checking for effective milk transfer, without asking 
the mother to express (she'd be better off just feeding the baby, 
yes?) or do calculations?  I'm assuming the baby continues to be well 
and there are no signs of  jaundice or tongue tie.

Here, a weight loss of 8 per cent on day 5 would be considered WNL 
even with a small baby, and the mother would not be asked to express. 
But she and the baby would probably be observed to ensure bf was 
going well.

(I am not a clinician - but this is the sort of situation I might be 
involved in, 'cos here it would not be considered to be clinical)

Heather Welford Neil
NCT bfc, tutor, UK
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