Thank-you, Pamela!
I have been asked for more information about this case. The baby had a TT and LT release 3 weeks ago. She has always been a slow gainer, 3-4 ounces a week. Mom is working on the right balance of supplementing extra breastmilk, of which she has plenty (not oversupply, just plenty) and listening to Baby's cues. She has been able to get Baby to take more feeds and a few bottles but she is refusing to drink as much as is offered.
The pediatrician wants the baby to gain faster. We actually think she may have finally started to but the mom wants references to give to the pediatrician of why it isn't best practice to add PIF to breastmilk to increase calories in case the weight gain is still low. The mom really likes the pedi and wants to keep a good relationship but is listening to me about solute load and the other dangers of PIF. The pedi has shown herself to be open to information.
I think the information provided by Pamela may be helpful.
Laura Spitzfaden, LLLL, IBCLC
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