Regarding the pediatrician who recommended apple juice for the 3 week old 
baby who wasn't pooping. Zena, this is where the HCP report of the lactation 
consultation is a great help. When IBCLCs send a report to both the pedi and 
OB, they can mention their observations and include relevant technical 
information to help train these doctors. I have had two WIC clients using 
the same pedi, both with babies that we at WIC think are way under weight 
(pedi said they were ok). I wrote up a HCP report and mentioned that we had 
told the mom(s) that normal weight gain for a BF baby is 6-8 ounces per week 
and by this standard "WIC was very concerned about the lack of weight gain", 
etc. I am hoping he is learning something and coming to realize he can rely 
on WIC. Our offices are within walking distance. This is also where careful 
phrasing comes in.

I would not say anything about the apple juice, rather that your concerns 
are the poor intake, evidenced by your test weights and by the lack of bowel 
movements. Be careful assuming that what mom thinks she heard is what the 
doctor actually said. Sometimes moms get things a bit backwards.

Some women who have not gotten off to a good breastfeeding start are able to 
recover and establish a full milk supply later. Others are not. This mom 
needs to give it a good two weeks of intensive work, hopefully she can do 
some pumping on a hospital quality or rental pump 4 times a day after 
nursing. The most important thing is to increase the amount of calories baby 
is consuming and hopefully also the time baby spends at the breast. Babies 
that are under birth weight often do not suck vigorously until they fatten 
up some. Make sure she is feeding baby plenty, at least 2.5 ounces of 
formula or breast milk times what his weight should be at this point, not 
his current weight. He may need several more additional ounces per day.

From what you describe as baby's feeding behavior, the problem may also be 
on his part. These are really tough ones to solve.

Good luck, Kathy Eng, IBCLC 

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html