Rachael, It seems baby had a 13 percent wt loss, which is pretty significant
at day 5, and certainly a sign of trouble. However, it is possible that the
first weight was an error. Things seem to have reached the bottom at day 5,
which is a little later than an uncomplicated breastfeeding course, but not
way out of line. Since day 5, it appears baby has gained 20 - 60 grams per
day, which seems appropriate to me. The baby has not regained birthweight,
which is what we'd like by now, but the latest info shows a good pattern.
Now, here is the question I have asked numerous times on lactnet before:
Is it better to accept a slow and steady weight gain on mother's own milk
alone, even going a day with no gain
OR
Is it better to provide extra donor milk or even formula to a baby, and get
a more robust weight gain?
I don't know how anyone can really answer this. Certainly when there is
donor milk available (one must take into account any cost to the family), it
makes it even harder to make a decision.
One thing I would like to say is, for this mother, using the donor milk, if
not truly indicated, will likely lead to a decrease in her own supply.
Here is another thing: I have recently worked with several mothers, with no
or slow gains, lower productions, and luckily these were motivated mothers.
In a relatively short period of time, with mainly improved bf skills, and
pumping, the supply has come up nicely. I would encourage this mother to
continue to work on bf skills in herself and baby, feeding very often,
pumping if needed to further increase supply, and continue to monitor baby's
weight, but not necessarily every day.
laurie wheeler RN MN IBCLC
Mississippi USA

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