Hi Julie,
My first priority would be to ensure the health of the child, firstly
adequate fluid and calorie intake, and secondly his general health.
His overall condition should be reported to his doctor if he is lethargic,
jaundiced, dehydrated, and has a weight that is worrisome.
Therefore, I would want a weight check. Then I would want to know exactly
what baby is eating (here's where the detailed records will
be of great help). Because, even if baby is drinking 2 or 3 oz of formula at
a feeding, how many feeds is he taking in a 24 hr day?
For example, 5 or 6 feeds may not be enough. (I don't remember the
birthweight.) You probably already know this, but some lurkers may not,
but an easy calculation is take baby's birthwt x 75 mls (or 2.5 oz) to get
an idea of the 24 hr total baby will need. So a 7 lb baby would need *about*

17.5 oz. Since mother is not producing much milk now, most of his calories
are coming from formula, of course.
I also want to know how wet the diapers are, how dark, or light, etc. And
the color and size of the poop. Since baby is predominantly on formula, I
would not be surprised if he had fewer stools, but I still would expect a
couple or 3 a day.
The second priority is increasing milk production, so you are addressing
that. At this point I would also be recommending a hospital grade pump,
like you have, and galactagogues. There is time to get baby bf but he won't
bf if there is no milk. So if he will latch and suckle then a
supply line can be used, if not, I use paced bottle feeding and lots of skin
to skin.
Laurie Wheeler RN MN IBCLC
Mississippi USA

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