Dianne,

Thank you for clarifying what the birth weight was.  Since it was actually
7-7, that makes a big difference.  My question now is:  How old was the baby
when it weighed 6-11 (lowest weight)?  Was the weight of 7-14 at 5 weeks of
age or 5 weeks since the lowest weight?  That can make a difference, too.
Was the lowest weight truly the lowest weight or did the baby lose a little
bit more in the next day or two?  Then the baby may have gained more than 19
ozs in 4 weeks 2 days, indicating a gain of almost 5 ozs per week...which is
more acceptable. 

I agree with you that the other two points you make are important.  In my
private practice, I suggest that the newborn be weighed naked and on the
same scale each time (scales in different rooms in the same pediatric
practice can differ by a few ounces).  One father once noticed that the
scale was not at zero before the baby was placed on it.  Occasionally, the
same scale may measure differently if it is moved.

Sometimes, our help can turn a situation around without supplementing but
all the while keeping a close watch on how the baby is doing.  How much did
the baby gain during the week before the supplements were started?  Is it
possible that the baby was turning the corner and would have been fine
without the supplements?  The physician might have been comfortable with
waiting another week.  Is there a plan for safely and ASAP weaning from the
supplements, especially the ABM?  Is the mom pumping at the end of baby's
feedings, rather than in between, to get the hindmilk and even the hind
hindmilk?  All of the above can make a difference.  There are cases that
need supplementing; we often walk a tight rope and the decision-making
process is not easy, although we do have some leeway if we are careful.

It is wonderful that the mom and baby have you to care about them and seek
out so much help.  Best wishes to all!

 

Lee Galasso, MS, IBCLC, RLC


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