Rayann, in my breastfeeding medicine specialty practice, I unfortunately see
babies like this all the time. This baby is significantly under the weight
we would expect, if breastfeeding had been going well from the beginning and
the baby were gaining weight as we'd expect if breastfeeding were going
well, a la the WHO curves  and Kay Dewey's work--back to birthweight before
5 to 7 days, and
then gaining an ounce to an ounce and a half a day. This baby at ten days
old was nearly a pound and a half under birthweight, at the age when she
should have been at or over birthweight. In my experience, as long as a baby
is significantly under expected weight, they are very poor feeders, they
conserve energy by only drinking when the fast flow (lower fat milk) reminds
them to drink, but they fall asleep and quit drinking when the flow slows
down (creamier milk left behind). The baby you describe has a weak suck
because of the infant's low energy, from being so underweight. They often
look quite alert, not lethargic, but their periods of good energy are brief,
and then fall asleep way too soon. So they get caught in a vicious cycle
whereby their being underweight makes them feed poorly, which exacerbates
their poor weight gain, and also slows the mother's rate of production. As a
result, their weight gain slows even more, and mother spends all of her time
trying to get her sleepy baby to feed better. Only when we intervene in
someway with this vicious cycle is the baby able to catch up on her weight,
and along the way, the baby suddenly notices her hunger, and begins to drive
the process. So you need strategies to increase mother's milk production,
and to supplement the baby with a feeding method that gives the baby faster
flow, and encourages much more intake. Pumping with a good manual pump
and/or manual expression, switch nursing, breast compression, galactogogues
and perhaps even donor or artificial milk supplements may be necessary. When
we do this, we see babies suddenly act much hungrier, and demand to drink
much more than before, and grow incredibly fast, putting on 2, 3, 4 and even
5 oz a day, so these types of interventions are not needed for long. A two
week old infant who is 24 oz behind will usually catch up completely within
about two to three weeks, often even shorter. I've seen babies gain a pound
over a weekend. And then, once the baby is closer to expected weight, then
suddenly the baby is totally driving the process, mother doesn't need to
work hard any more, breastfeeding is going well, baby gaining, and any
earlier problems, be it so-called 'nipple confusion,' stuck on a shield,
breast distress, or whatever, (in your case the weak suck) are suddenly
easily resolved. I don't really care about the numbers of the weight per se,
but what I see is that when a baby is behind, by my calculations, they don't
feed well. Once they are caught up to where the baby wants to be, regardless
of whether that exactly matches my best guess as to "expected weight," once
the baby is where the baby wants to be, feeding is easy. This is the bottom
line, not the weight by number. Tina Smillie MD IBCLC FABM

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
Mail all commands to [log in to unmask]
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or [log in to unmask])
To unsubscribe: unsubscribe lactnet or ([log in to unmask])
To reach list owners: [log in to unmask]