Using breast compression, as Jack Newman describes, at the same time may

> also increase yield.  It may be something about the latch or the
well-used
> breasts, that is not stimulating production as well as earlier babies
did.
>
> Jo-Anne Elder Gomes, mother of multiple multiples, where are you?
Doesn't
> this case ring a bell with you?
> Rachel Myr
I agree with Rachel (of course). I would encourage the mother to be
particularly attentive about bowel movements, and would be reassured if
the stools were not only frequent and substantial but also the "right"
colour and odour, to indicate that breastmilk (and what I was taught was
called hindmilk before current research obliged me to doubt that term)
was being transferred.
A slow-gaining baby can be a baby who was born excessively large, in
proportion to the "normal" weight he or she will have at one year of
age, indicative of his or her adult weight. (Rachel, would you call this
"over-voluptuous baby syndrome" or "disproportionately large baby
syndrome" ?) That is why the "non-interventionist" method of looking at
the size of the parents can be an important part of the family history.
On the other hand, I tend *not* to be complacent about these things,
would be worried about waiting to see what happened naturally at one
year of age, and would suggest that hand-expressing a bit of breast milk
into a medicine cup and giving it as dessert -- that is, perhaps not
essential to the diet but welcome -- wouldn't hurt. This would fall into
the category of information I might give as "If you are concerned that
the weight gain may be of concern, you could try..." or perhaps "I think
you might want to consider..." depending on the context and the degree.
It may also be that the baby has been skipping lunch as well as being
deprived of dessert, and that a pump might provide reassurance to the
mother and/or the helpers. Do others agree, or am I reflecting the
paranoia that led me to my current area of work?
Jo-Anne Elder-Gomes, IBCLC, mother of slow gainers.

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