I have to agree with Laurie that parents are often not really good at 
judging what is and is not normal, mostly because they don't have any 
frame of reference, nor do they have experience. They also want everything 
to be going right.

I know that I find, especially in the outpatient setting (especially when 
I don't happen to know the pediatrician involved) that often the peds (in 
trying to be supportive of breastfeeding and Mom's desire) do 
underprescribe the amounts these babies should be getting. I think in 
their hearts they know too much formula will undermine Mom's supply but 
are at a loss as to what really needs to be done. I always surprise myself 
when I find myself saying that the baby needs a prefeed (or an actual 
feed) of at least 2-3 ounces ever two-three hours while getting mom's milk 
in, etc.,and the pediatrician has been far more lax in his/her 
recommendation. In fact, I just finished a case where there clearly was 
not nearly enough breastmilk yet, the baby was over a pound under 
birthweight at almost two weeks and the pediatrician had told the mother 
that a brown mucousy stool was okay. Now granted, sometimes it is the mom 
who is undermining herself (as was the case in my most recent case) and so 
I am sure it is difficult for the practitioner to be able to read the 
situation. I always feel lucky to be able to be going into the home and 
really see what goes on, because the pediatrician certainly doesn't have 
that ability.

Betsy Riedel RNC, IBCLC
Connecticut

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