Linda, I agree with you wholeheartedly re needing to assess what this baby is actually taking at breast, and had emailed the mom offlist.  I would suggest though, that I would recommend (which I did) pre and post feed weighs and IBCLC direct consults, perhaps thus avoiding the probably bottle use.  The consult should determine the need (or lack thereof) to measure inputs.

I think many moms interpret "to see how much he's taking" as "to see how much I'm making", and there's a HUGE difference.  I've had MANY moms, especially new G1P1's for whom this advice was nearly the end of BF.  They are already overwhelmed, they don't usually have an appropriate pump and don't understand the need for one over another, they almost immediately decide that bottlefeeding the pumped milk(if they get any) is easier than at breast and don't go back, but my biggest concern is that they aren't bonded to the pump, don't let down well, get totally discouraged, and switch to full formula feeding ASAP.  It sounds so easy to them, but they don't understand the complex physiology or all the things that can throw it off.  Then they begin blaming themselves for starving the baby by breastfeeding.  I've had moms who couldn't pump even drops whose babies were taking 2 or more oz at breast by pre/post weights.  They were going to quit because they thought they weren't making "enough".   So please, anyone (most often well-intentioned, non-referring peds in my experience) out there suggesting moms pump to see how much they're making, please suggest a visit to an IBCLC and pre/post instead.  Better yet, if intake is an issue, offer her a ride.
-
Kay McKee IBCLC

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