This baby had regular physician visits. I do not know why the slow weight-gain was not addressed earlier.

There were no scheduled feeds. He was just one of those babies who seems happy to not get enough. The mom is very connected and nurturing and just didn't know anything was wrong. She was feeding her baby on cue with no signs that he wasn't content and developing normally. She was even pumping every day in addition to breastfeeding to store some milk and that is what she used to supplement.

I forgot to mention that his hemaglobin was low and this may have contributed to a lack of appetite. He is now receiving supplemental iron.

I did do a pre and post feed weighing and he was able to transfer 88ml in 25 minutes. Mom still had milk left after he would no longer latch. This is why we started with increased feeds to see if Mom could supply all he needed. His suck was very dysfunctional and his frenulums were very restrictive. He has improved greatly since the increased feeding schedule, frenotomies and CST. He has had some significant weight gain but Mom's supply is just not quite where it needs to be for him to have catch up growth. He was still gaining at an ounce a day with just 4 ounces of supplemental breastmilk a day and for two more days after supplementation ended. She is just so close!

Laura

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