I agree with Heather. The key is to maximize baby's intake. I have seen
many babies with early poor gain due to (in my opinion) pacifier use /
misreading of cues. Pacifier use is rampant where I practice. Parents just
don't put the baby to breast when they cue, they instead give the pacifier
if there has been a recent (w/i 3 hrs!) feed. I've heard some say "he loves
his pacifier!"

Recently had a case (I knew the family but was not the LC) where the mother
swore her 2 wk old was teething. She said she read that babies could begin
teething at 6 wks and her baby was close to 3 wks old. Baby was chewing
hands. Besides that most of the pics she  posted on social media showed the
baby with the pacifier in the mouth. The weight gain was poor - not back to
birthwt at 3 wks but the doctor was satisfied. Apparently said the baby had
put on a few ounces and had grown in length. Luckily, several worried
contacts including me convinced the mother to see the WIC and/or hospital
LC and she was advised to feed round the clock, discontinue pacifier,
express and comp with more ebm. Has pacifier use been explored with this
mother?

I think the mother's energy level could be a factor, if she is anemic and
with 3 other children, and what does she eat? Quantity and quality of her
diet as far as her anemia. It will be quite important for this baby to get
regular weight checks for a while.

Laurie Wheeler RN MN IBCLC
MISSISSIPPI USA

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