Thank you all for your responses! I  basically told the mother most of the same things when I talked to her just before posting last night. She did see her Dr. again this a.m. and he has referred her to a pediatric gastroenterologist. Her regular Dr. is an older physician. She maintains that the baby again transferred 2 oz. after nursing this a.m. She is doing the weighing and is using a digital baby scale, weighing with just a diaper before and after nursing (not changing diaper). Teresa, you mentioned that was not enough. I do not usually rely on before/after weighs to be very accurate and have told her this. How much would be "enough" if there was such a thing/state of being? Baby has normal amount of wets a day. Someone mentioned baby's weight's from birth. Mom reports baby dropped down to 8#2 but has been gaining .5 oz. a day for the past week. 
I had hoped the Dr. would recommend she start other supplements today but he didn't. The midwife is remote to the mother at this point, as well. The mom actually traveled about 3 hours to birth the baby at the midwife's residence, where she stayed for 3 days pp. I did mention donor milk but unless it is informal donation, there is not that option for this mom -- and even then I don't know if that's an option. I did ask her to ask Dr. or midwife for kind of formula, should she choose that. I did tell her it was past time to seriously consider more intense supplementation. I let her know this was far to complex for me to give her reliable help -- we are at least 8 hours apart. 



Liane C. Varnes, IBCLC

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