Kristen, if this situation were occuring at my hospital, I would use 
your 4th choice: 

-What about test weights? Nurse fears that if we don't get the volume we are 
looking for (about 1.5 oz ballpark) we send a powerful, negative 
psychological message to mother....she may very well be right. On the other 
hand if there was good transfer we could d/c supplement and the bother of 
expressing.


However, I'd be satisfied with a volume of about 1/2 oz. (15 ml) and be 
thrilled if baby got more. And I'd have the mom do compression and 
massage towards the end of the feeding to increase milk transfer.  If 
the milk is just coming in I doubt if he's getting 1.5 oz., but by the 
end of the day (in normal circumstances) he will be. I often do these 
kind of weights if the doctor is concerned--in most situations, just 
hearing that mom's milk is now coming in is enough to satisfy them.  I'm 
assuming there are no major risk factors for this mom and baby, and also 
assuming you have a Babyweigh or other gram scale.  I see weight losses 
of 10% fairly regularly, unfortunately, but if all the signs are 
otherwise normal, it doesn't seem to be a problem.

Becky Krumwiede, RN, IBCLC
Appleton, Wisconsin

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