Jack Newman writes:

<<
 I have lots of patients whose babies were below birthweight at 2 weeks, some
quite a bit.  We
 fix the breastfeeding, and the baby starts to gain.  No supplements are
suggested or given in a
 majority.
  >>

Dear Dr. Jack,
Gosh, can I stand by what I teach and agree with you at the same time?
 Before supplements are even suggested, we should fix the breastfeeding.
 Before the baby fails to regain birthweight, or continues to lose weight, we
should fix the breastfeeding.  Before the baby is out of our care in the
hospital or homebirth, we should fix the breastfeeding.

Most of the situations of weight loss we find ourselves in are due to poor
management (frequency and duration are limited) or poor emptying of the
breast (infant is poorly positioned or latched on).  In either case, we've
failed to give mom and dad a good understanding of *normal* breastfeeding
behavior.

Well, let's face it, we don't know what *normal* is ourselves.  We don't know
how long a baby can safely go after birth before feeding for the first time.
 We really don't know how much weight loss is normal.   We don't know how
long it takes a cord to fall off if we leave it alone, for heaven's sake.
 And we don't trust the bell curve.  We quantify everything, give everything
an average, and then the *average* becomes *normal*.  Not the same thing.

I guess I'm responding to the parents who are told that their baby is
*allowed* to lose 10% of birth weight before a breastfeeding assessment is
considered.  Way too late, IMHO.

I'll get rid of percentages, Jack, if we can lose the averages.
:-D
Jeanne