Thanks to everyone that responded.

In answer to Laurie's questions - I did do test weights and the baby transferred almost 3 ounces. That was impressive since she was only 5# 10 oz. It had been 6 hours since her last feed though, but I knew this baby could transfer an adequate amount. The interval clouded the issue a little and I suggested she rent a scale to do test weights at each feed. 
This mom had successfully breastfed her 7 and 9 year old and felt certain the breastfeeding was not the problem.

She was right. The baby has been diagnosed with Cystic Fibrosis.

The baby is now getting enzymes and hopefully will start to grow.

One of the things I LOVE about lactation is I learn new things, even after 13+ years. When I first got report on this case (before I saw the couplet) I was sure the baby must not be getting enough. I was wrong and the mom was right. I need to not jump to conclusions before I see the whole picture.

Andrea Tran RN, IBCLC
Boulder/Erie, Colorado

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