This has been so educational to me.  In two years time, when I take my IBCLC exam, I will be grateful for this experience.

Thank you, Rachel, for your additional comments about the birth weight.  Baby was born at 39 weeks. Extremely fast labor, to the point of almost having baby in car vs hospital.  No birth complications, or meds.  I was suprised at how small baby was, given the health history of mom (non-smoker, very conscientious) Mom gained less than 20lbs during pregnancy.

At first, mom was pumping and bottle feeding some due to extremely sore nipples.  That was the original reason for my referral to the LC.  Mom was in a lot of pain.  For a short time, she was only able to nurse on one breast because of soreness.  The soreness has resolved now.  At first, baby was getting some EBM , and I encouraged direct BF as much as possible.  Now Mom is not pumping.

Mom has been in contact with me consistently since the birth and I can't tell you how many times this Mom has said to me "Baby just doesn't seem satisfied."  All along, I have been trying to determine if this is a breastfeeding management issue or a baby personality issue.   Without a tool like the scale, I would never have known that we are dealing with a BF issue and referred Mom appropriately a 2nd time.  

As soon as baby hit the "above birth weight" mark, baby went off the radar of the pediatrician.  It was only because of the "not satisfied" issue that Mom returned to me for a weight check.  Even with a weight loss of 3.5 oz in a couple of days, pediatrician was not concerned because again baby was above birth weight.  Only when Mom called again with no weight gain after 5 days that they suggested supplementation.

I can't tell you how much I appreciate the support of this group because I have lost sleep over this.  I want to make sure I alarm appropriately.  It is a fine line to support mom during this challenging time, while seeing potential medical issues that are totally outside of my scope, especially with a pediatrician who is not taking mom seriously.  You gave me great suggestions that were within my scope and helped me to help mom before her LC appointment.

When I saw mom and baby yesterday, I paid strong attention to the time baby spent swallowing.  About 10-15 minutes of swallowing during a 45 minute session.  Baby had gained 1 oz in 24 hours on my scale.  They will see an LC today.

Again thank you! 
Lisa

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