>> I have a mom who is trying so very hard to breastfeed her baby. The baby latches very well. He is 3 weeks old. His birth weight was 7lbs 13oz. He dropped to 7 lbs at 4 days old, but regained to 7lbs 8oz and has not gone up since. Baby looked scrawny to me, but not worried or terribly upset... >>


Scale differences could be one aspect. What kind of scale is mom using? Is it reliable? Is the same one always used? Is baby weighed naked? Is baby weighed at the same time of day? 

Data available indicates the baby was on the way up again from lowest known weight. What changed to create a real or a perceived "stall"? Data later in your post indicates mom is producing well and baby is able to effectively transfer that milk. 

I'm wondering what the baby's primary care provider thinks -- when has baby been in/or when scheduled for a check up. 



> I watched this baby latch on - I heard gulping in the first 5 minutes, then baby slowed down to a much slower suck/swallow pattern for another 10 minutes. He took 74ml on the right breast. We switched to the left breast - same scenario, baby took 28ml over minutes. >> 


Baby took in 102 ml (3.4 oz) in typical breastfeeding kind of times -- not sleepy and drifting off in minutes, not overlong, etc. That's terrific and seems a good amount for a 3 week old. I'm assuming baby was allowed to self-detach for each breast and still left milk in the breast -- also typical with "at breast" regulation.

I'm kind of wondering why supplement up to 45ml when the baby appears to be effectively transferring milk? 

You didn't mention how many breastfeedings this baby typically has in 24 hours or whether mom is also trying to time them. 

I'd probably want to give ad lib/cue-based breastfeeding (perhaps a "babymoon") with self-detachment a chance for a few/three days and one daily nude weight on a reliable scale and then reassess.

Something just doesn't add up when a baby is effectively transferring milk (also assuming test weighing was with a reliable scale), having numerous stools (and wets) but isn't gaining...



> The only other thing mom mentioned is that this baby stools constantly, all day long. Not green and frothy stool - yellow (I saw it). Sometimes she has to change the baby 3 times during one feeding! This did not happen during the consult. >> 


Did the baby's stool look like typical breastmilk stool in other aspects? Can think of babies who have wet farts and stain the diaper several times a feed. When mom says she sometimes has to change the baby 3x/feeding, how much stool is actually in each of the 3 diapers? Or is she jumping up to change small amounts each time, which interrupts/disrupts baby's feeding too. 


Will be interested to hear follow ups.

Karen

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