Hi! Leanne here.
We have tried very hard not to give any formula but we are finding that culturally Latinas think unless they are leaking copious amts of milk they have insuffiencient supply.
If baby loses >7% in first 24 hrs the pedi/neonatologist will ask us to consider formula up to 20ml after breastfeeding occurs. If >10%? then they are evaluated and again supplementation will be ordered. If loss is < 7% then we don't supplement.
Our area is highly litiganous and we see jaundice occasionally more than at other times. If Mom can't pump enough for feeding under the bili lights we then add to bring the feeding to equal 1 oz(30ml) every 3 hrs.? 
We spend much time and effort trying to get everyone on same evidence based page. And it can be an enormous effort.
Currently we have a lot of great number of babies that are breastfeeding well...if we could figure out why one batch is more interested we could parlay it and bestow it on the ones who are sleepy.? 
I think some of it is who is passing the epidural/spinal meds.
We don't always push the formula...actually I would rather push more time breastfeeding...some of our challenges are more cultural even among the Latinas. South Americans come with breast surgery issues, Central Americans breastfeed the best. Recent arrivals from Cuba do better than aclimmated ones and Caribbean Hispanics are more like the Cuban women who have been here for awhile. If they are returning to their islands you will see different perspectives.?We are always looking for ways to entice and get around all the folklorica drama.?
Education is the most essential part of our job and it often is the most challenging...especially if grand mother is challenging the information.
Trust me we endorse breastfeeding exclusively.
Leanne Jewell RN-BC, IBCLC,LCCE, FACCE
South Miami, Fl

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