Mellanie
I have some thoughts. The baby needs about 18-19 oz per 24hrs based on b.wt
(7.5x2.5) so if he eats 2 oz every 2 hrs he will get 24 oz a day and should
gain very well. If he is actually only getting 8 feeds per day (every 3 hrs)
then he is only getting 16 oz per day and he is falling short of his needs.
I explain this to parents and staff that if you need 1800 cals a day to
maintain your wt and I put you on a 1600 cal diet you will lose wt. So even
if the babe is getting just a little less than what is calculated to be
needed, he will not gain. This method of calculating has never failed me
yet. Of course I explain to parents the baby should not be restricted but
given more if  he wants more. That covers rule no. 1 "feed the baby." Of
course use direct bf, and next ebm feeding to the greatest extent possible
but often formula is also needed til the milk supply catches up. this moves
us to rule no. 2 "maintain/increase the milk supply". the mother could use a
nursing supplementer for some/all feeds, this tends to increase time baby is
actaully at the breast. mom could pump postfeed or try for 8-10x per day.
she  could use other/more herbals. there is info in our archives or in many
books or herbal galactagogues. also explore domperidone as a prescription
galactagogue. make sure there are no health problems overlooked like
infection, birth defect, cardiac, etc.
not sure when mom will get a 'full supply' becoz did she have any primary
breast problems? in any case mom should continue her efforts it may take
many weeks but it may be sooner.


Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA

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