>
>
>Although there is always the outside chance that this baby is suffering from some disease state which prevents him from gaining weight in spite of adequate intake, the most likely situation is that the baby is not transferring enough milk - wet diapers do not equal milk transfer.  Scant poops, which you mentioned in the previous post, are a strong indicator of inadequate intake.  How do you know that the baby is "nursing well?"  All indications are that nursing is not going well at all.
>
No, I don't know positively.  Which is why I have recommended she 
contact someone who can evaluate her properly, which I cannot do over 
the internet.  I am trusting the fact that she did nurse one baby 
successfully and probably knows what "good nursing" looks like to some 
extent.  Plus, she says he is a happy baby who is awake and meeting 
milestones.

None of this is proof obviously and I *am* worried for her which is 
exactly why I strongly recommended she get hands-on help for this 
situation, and posted to find someone to help her.  :-)

>  You mentioned a history of slow weight gain babies. It could be that the mom never had an adequate supply.
>
It could be.  The first child was raised (18 mos) in Poland and the 
polish doctors didn't seem worried about his slow weight gain.

>If baby is not nursing properly, then the use of a pump may be crucial to reestablishing a supply.
>
Yes, it might.  I did say that pumping was an excellent thing to do 
between feeding.

>  And the SNS is not always the best way to supplement - there are many factors to consider. Please do not take offense at these replies
>
:-D Believe me, I am NOT someone who takes offense easily.  :-)  I have 
very tough skin.

>simply painting the doctor as the bad guy solves nothing - in fact, this doctor may be doing his best to try to work with a mom, who although she is worried, refuses to see that she has a very serious problem which may require intensive supplementation
>
You are right, painting him as the bad guy may not help.  But she is 
supplementing him, and accepts that may be necessary short and/or long 
term, but wants to keep nursing.  She herself says he is not 
breastfeeding friendly but only "goes along with her" to humour her as 
long as things are going ok.  Which they're not at the moment.

>The ideal situation is an experienced IBCLC
>
> working with a supportive physician and a motivated mom who really wants to understand her situation and develop a realistic plan to address the challenges she is facing.
>
I agree.  I don't know if the supportive physician will happen given the 
military situation.  But I too hope that she gets the help she needs to 
successfully nurse this baby with OR without supplement.

>would not give the baby the amount of supplementation necessary to maintain adequate weight gain.
>
That is not the picture I am getting here...she has been giving 
supplements for several days now she says, and is not adverse to doing 
so particularily, but does want to nurse.  Having seen her other two 
children grow up as slow-gainers, one breastfed the other mainly 
formula-fed after a while, she is concerned there is another issue with 
this baby that is not yet being explored.

>You have no way of knowing what is really going on here.  So I do hope that she is able to hook up with someone who can visit her in person and get a handle on the situation.  Good luck.
>
No, I don't know what is going on here.  I have forwarded her some 
contact information and she thanked me profusely.  I hope to hear back 
from her with good news, but I have done what I could do.  :-)

Thanks for your thoughts.  You know what occurred to me...I don't know 
if this is even POSSIBLE, but let's say the baby has a lot of foremilk 
but doesn't get to the hindmilk, would that perhaps cause fewer poops 
(scant and far between) because of less "milk solids" to come out...and 
what if when she starts supplementing, the formula causes constipation? 
 I just thought of that and wondered if that is even possible or if it 
is entirely far-fetched.  Not that I would go and mention it to her 
since I think it is useless to mention all the different aspects of what 
COULD be wrong and worry her more.  It is out of my realm and I know 
that and I hope she seeks help with someone nearby.  :-)

Fio

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