I have been requested by a pediatrician in my hospital to do a "lactation consult" on a 38wk SGA baby
(wgt 5lb 2oz). The baby is 48hrs old and is acting like a "well baby". No hypoglycemia/hypothermia. The
ped is concerned that the baby has lost 150gm since birth. Several voids/stools. Baby circumcised this
a.m. so he has been rather sleepy today afterwards.However, baby did rouse and breastfeed well on one
breast per feeding every 3hrs. The doctor also ordered the staff to do ac/pc (test wgts) on the baby and if
not gaining 15gms per feed, to supplement baby with formula. I contacted her to ask her to discontinue
the ac/pc wgts as they are not accurate prior to an established milk supply. I also asked her what is the
"medical indication" for the supplementation. She could not give me an answer other than "this baby can't
afford to lose any more weight".  Is there something I'm missing here? Is there any baby that gains wgt in
the first 3 days of life realistically? She agreed to dc the wgt checks and the supplements but left me with
a "threat" that if baby had not gained wgt by tomorrow she would definately start supplementation. I know
full well that there will be even more wgt loss by tomorrow, so how should I approach this? I have
instructed mom to pump her breasts after each feeding and give the baby any expressed colostrum by
cup until I get back to work tomorrow.  Any help with research to show her tomorrow will be greatly
appreciated.

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