Cindy and all,

My impression of this baby from your description is that he's not getting
enough  to eat.

He's nursing  "constantly" because he's unable to get enough as he nurses.
He's probably not "colic-y" he's most likely HUNGRY.

Whether it is inefficient sucking on his part or an intrinsic breast
problem (less likely based on what I've seen in the past) is something to
investigate further.

As Coach Smith has rules, so does Dr. Gail:
#1 Feed the baby
#2 Empty the breasts
#3 Follow up frequently

#1 Feed the Baby
I base my initial supplement on age, weight loss, lack of weight gain, and
how undernourished the baby seems based on a physical assessment.

A 6 week old full term baby should be getting 100cal/kg/day -- that does
not include calories for catch-up growth.  We generally use birth weight to
determine  the number of calories needed.  At approx 4.4kg, that comes to
440 cal/day - now dividing by 20 cal /oz  that gives a figure of 22 oz of
something liquid worth 20 cal/oz that the baby needs in a 24 hour period.
Then, depending on the scenario, I factor in what I think the baby is
managing to get on his own, and what changes have been made at the visit
(now can latch, better position, awareness of feeding cues, etc.)
Part science, part experience, part intuition.

#2 Empty the Breasts
I never assume the baby is doing an adequate job of emptying the breasts
when there is a problem.  I always request that mom pump with a hospital
grade pump.
I want to be sure that the breasts know what I want them to do - make lots
of milk!

Besides that, EBM is my supplement of choice.

As to the part that she was so busy, when the baby gets an adequate meal
(with the help of supplements) he won't be constantly in feeding mode.

#3 Follow up Frequently
I'm a pediatrician that thinks 1 week is too long for a baby in trouble to
go for follow-up.  I will bring some back the next day if I need to, to
make sure they are not becoming dehydrated or losing weight. 3 or 4 days is
the outer limit of my comfort zone.  This allows me to check for weight
gain, general health, how mom's holding up - and to allow me to adjust
supplementation up or down as needed.

I'd  be interested to hear how others decide on their plan....

Gail
Gail Hertz, MD
Pediatric Resident
author of the little green breastfeeding book - disclaimer: owner of Pocket
Publications