I think that no gain means not enough milk transfer.  Baby is drinking 
enough to maintain, but not enough to grow.

Have you done pre and post weights to show the baby is actually drinking 
well and not just looking like she is drinking well?

I have worked with clients who were on baby 3 or 4 who have milk supply 
issues with this baby, even through they had no issues with previous 
babies.

Often the culprits were, thyroid hormones out of whack, retained 
placenta, and lip/tongue tie issues.  Sometimes a combo of all 3.

Pumping early and often can give you an idea if this is a supply issue 
or a demand issue.  Also, confirm that the mother is indeed 
supplementing as often as she says she is.  I have had clients who tell 
me that they are supplementing often but then when I start asking 
specifics it turns out that they weren't really.

I have also found that sometimes mothers who have had previous 
successful lactation experiences can be reluctant to believe there is 
something wrong this time.  They might be reluctant to pump as needed, 
take medication to help with thyroid etc. because they feel it all 
should just work out like it did before.

-- 
Tania Archbold B.Sc., IBCLC
Mother's Nectar Lactation Consultant Services
519-400-7098
www.mothersnectar.ca

On 2014-09-24 15:20, Fiona Creina wrote:
> This case has me stumped
> 
> Baby 8lbs, 8oz at birth, down to 7lbs 12 oz on Day 3, baby has
> maintained 7-12 until yesterday when she was 7-13
> 6-8 wet diapers/day, one yellow poop/day, baby well, alert, not
> jaundiced, active at breast, lots of milk, good signs of transfer,
> feeding every 2hours, supplementing with EBM by finger feeding
> Mother is an experienced La Leche Leader and this is her 4th child
> 
> Has anyone seen this?
> 
> Thanks,
> Fiona Creina
> Student Midwife
> 
>              ***********************************************

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