Toni's client delieverd at 36 weeks and baby regained birthweight,  then
gained weight adequately, and then continued to gain weight slightly more
slowly for the next five days. After seeing the paed, Toni tells us

"So mom is nursing, giving expressed milk and supplementing with formula."

Don't understand why this is thought necessary.

Seems to me this mother has done well in establishing bf, to the extent the
baby is growing. While it would reassure everyone if the weight gain was
brilliant throughout the fourth week, surely pumping and supplementing are
things that are only tried  *after*  trying to improve the bf - increase
the number of  times the baby comes to the breast, check latch and position
(esp on rt side where there is pain and engorgement),  offer second side,
wake baby if necessary and for a feed to be watched to check mother isn't
assuming feed is over when baby is taking a break.

Pumping and supplementing with formula is likely to make the bf worse, not
better, and is likely to increase the mother's frustration - is this not a
paed's attitude and knowledge problem rather than a bf problem???

Heather Welford Neil

NCT bfc Newcastle upon Tyne UK