I would not be at all reassured by this baby's wt gain. Going from 6#11oz to 
7#14 in 5 wks is a little less than 4 oz per week. In my experience, healthy 
babies gain about a pound every 2 wks. The most common scenario I see for 
the baby who has lost a great deal of weight (like this one did about 10%) 
is a very large catch-up wt gain in a day or two. That is provided, of 
course, that the baby is receiving the appropriate volumes and calories 
during those couple days.
Since you are not able to see the dyad, it would be prudent to recommend a 
skillful LC to evaluate the infant's breastfeeding and the history and 
physical of both; and also close f/u with the physician. The mother may very 
likely need intensive stimulation of her supply at this point.
Formula supplementation, while appropriate for providing calories and volume 
to the deprived infant, does not solve the breastfeeding problem nor the 
milk supply problem, if there is one, and should never be recommended 
without this other most important part of the care plan.

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

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