Mandy, I would want some test weights to see how much baby is removing from the breast. The only way to really tell what baby is taking from the breast is to do test weights on a scale weighing down to 2 grams. He isn't nursing often enough, or long enough. I have seen babies act like this baby and the test weights showed 20-30 ml intake only, and about 12 oz per day only. The other concerns would be a poor milk supply from his lack of intake.  Mom might consider using a rental quality breast pump and pumping like crazy (8-10 times in 24 hours) to see if she can increase her supply. Probably is time for liquid supplements rather than solids (breast milk or formula). The Breastfeeding Answer Book has a good chapter on how much weight baby should be gaining, correct growth perimeters, etc. 
Best wishes to you and this mom, Kathy Eng, BSW, IBCLC

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