Hi All,
First I want to say that I love Lactnet and have enjoyed reading it for two years now.  I have a question that I have posed to a few FB groups, but I've not received an answer that truly addressed my question.  Maybe it's the way I'm phrasing it?  Hopefully someone here can enlighten me :-)  PTP

I have a client with low supply, baby is 4.5 weeks old.  I started working with her at 2.5 weeks.  Mom has multiple possible reasons for her low supply, including PTT/LT in baby that were undiagnosed until I saw her, and history of infertility and hypothyroidism.  We are working on addressing all of these, and the mother is 100% committed to breastfeeding.  She has been supplementing with ABM at breast at every feeding since day 5.  

My question is regarding baby's rate of weight gain and intake.  This baby weighs 10 lbs 11 oz.  In the last 7 days the baby has been taking about 20 oz of ABM per day and gaining 1.5 oz per day.  The mother believes she is making only a few of ounces a day based on pumping output (5 mls 4x a day, her choice) and weighted feeds (0.5 and 0.7 oz at our two visits).  I told her I think she is making much more based on her supplementation amount, baby's weight gain and the unreliability of pumping outputs in gauging supply.  How can we tell how much milk a baby is getting based on a baby's weight gain that is greater than 1 oz/day?  For example, if this baby needs 30 oz/day (to gain 1 oz/day), and is taking 20 oz ABM/day, clearly she is getting more than 10 oz of breastmilk at breast if she is gaining 1.5 oz/day, correct?  Is there some sort of formula to this?  

I hope I'm making sense!

Thank you,
Tanya Powell, IBCLC
SF Bay Area

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