Dianne, I tend to follow the guidelines in the newer books where 6-8 ounce a 
week gain is considered adequate. This is what the newest BAB says. I would 
tend to think that this low of a gain might be from the formula usage. It 
would depend on how much baby is getting per day (how many ounces of formula 
I mean).

The new formulas tend to make babies have lots of loose BMs. For example, at 
Texas WIC we give Enfamil Lipil and those babies have 3-4 or so BMs every 
day, loose and runny. So if mom is using the new formulas, the baby may be 
pooping alot from that. When I am doing a history and hear that mom is 
giving any formula and that baby has a lot of BMs, I put question marks in 
my mind.

The best thing would be doing a test weight for a couple of feedings and see 
how much baby is really taking at the breast. If baby is taking plenty at 
the breast, and I use the guidelines from the BAB of 2-2.5 ounces of breast 
milk or formula per pound of baby's weight, then I wouldn't worry about the 
slow weight gain. The other thing I look for is body fat, nice plump skin, 
no saggy skin, or "skinniness."

Kathy Eng, BSW, IBCLC 

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