Dear Cee, this sounds like a typical case of too many bottles in the day 
leading to a low milk supply or breast rejection. Is mom able to hand 
express or pump? If not, her milk supply is probably very low. I usually 
suggest that baby be limited to 12 ounces while at daycare. This would 
be approximately 4 bottles of 3 ounces each. What I find is that baby 
often gets 4 very large bottles during the day and starts to reject 
nursing in the evening and night. I have talked to moms whose daycare is 
giving 3 or 4 bottles of 6 ounces each. Also, a three month old baby 
should probably be nursing 8 times in 24 hours (or more) to keep up the 
supply. If mom is pumping 3 times, then she needs to nurse at least 5 
times. Many moms slack off to only 5-6 nursings/pumpings at this early 
age, which doesn't seem to keep up the average mom's supply. And I would 
suggest a slow flow bottle nipple if she can find one in Malaysia. Did 
she go on any kind of hormonal contraception method?

Kathy Eng, BSW, IBCLC

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