I certainly share the concerns of whether a little hunger is preferable to giving formula. If you check the archives over the years, you will see that I have raised this question on multiple occasions. Please do not think that I take this situation lightly. In every one of these situations, the mother should be advised and assisted to increase her milk supply as much as possible, and the baby should be assisted to increase his consumption of milk and milk transfer abilities - this is an ongoing thing and the goal is for mother/baby to be fully breastfeeding at breast at the soonest point in the future. This does not always work out. At this point in time, and I have stated this several times in the archives, I personally am deciding to give the formula if there is no way to increase the supply to the point needed, increase the milk transfer to the point needed, or use donor milk. As I mentioned in a recent post, a situation in which a baby had not lost alot of weight, and was gaining slowly but steadily would not automatically be a reason to supplement. Always each case is a judgement call, of course. But some of these recent cases were more stark than others. The research is definitely needed, however, one must look at the ethical implications of withholding nourishment and calories long term from a baby. Until then I do appreciate when I see a baby improve dramatically in a day or two with adequate nourishment, and also the baby's ability to breastfeed often improves along with his strength. Laurie Wheeler, RN, MN, IBCLC Mississippi USA *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html Mail all commands to [log in to unmask] To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or [log in to unmask]) To unsubscribe: unsubscribe lactnet or ([log in to unmask]) To reach list owners: [log in to unmask]