I know this has been debated before, but I have to add my two cents...

I know clinical skills are useful, and MOST of the time when I put a baby on 
the digital scale after abserving a feeding my estimate of intake is pretty 
close to what is on the scale.  HOWEVER, every once in a while (maybe twice 
a year) I watch a kid swallow over and over, only to find he took 2 cc from 
the breast.  The other day I had one of these...a 3-day-old who appeared to 
be gulping and swallowing for most of 10 minutes, and had transferred only 2 
cc.  The mother's breasts were feeling full, and based on visual clues 
alone, I would have said her milk was coming in and she could go home and 
nurse ad lib, even tho the baby was 9% below birthweight at less than 72 
hours of age.  Instead, she began pumping and supplementing.  (In part, also 
because she has a history of prior lactation failure)

I don't know what these kids swallow...must be their own saliva...or 
extremely small "boluses" of milk?

Kathy Leeper, MD, IBCLC 

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