Anne writes: " Baby boy, mom's third, BW 7#7oz, up to
7#8oz at discharge, down to 7#7oz at 14 days. Began supplementing with 20CC
formula in SNS during every bf."
Well, I'm gonna be controversial here. Here, the first advice would *not*
have been to supplement (and 20 cc? every feed? that is quite a lot ).
How were those weights done? We've heard a lot on the list of how
unreliable even reliable weigts can be. *Was this baby ever observed
feeding?* Would a change of position, a correction of latch, encouragement
to feed ad lib, have helped? Was the mother feeding *a lot* and giving the
baby every opportunity to feed? We should be encouraging her to make sure
the baby is at the breast at least 12-15 times/24 hours, with plenty of
skin to skin, and night feeding ad lib.
Clearly, an (apparent) net zero weight gain is not great at 14 days but it
is not disastrous, and I have observed many babies who have started to gain
well after this time - the production of wet and soiled nappies and the
general appearence and behaviour of the baby is part of the general guide
to health. Why rely on weight only, esp. when we know how unreliable this
can be? Fix the bf if necessary, give lots of support, and then wait and
see for a week or so. Supplements, however given, can *interfere with the
establishment of a good supply*.
"Baby making at least 4 sometimes 6 or more wet cloth diapers/day. But on
Day 18 baby was dry for 3.5 hours. "
Is that a true emergency? Most babies do probably wet more often that this
at this age, but this could have been a one-off...why not just bf without
the large supplement first and wait and see (providing the baby had no
signs of truly serious dehydration, of course). When had the baby last fed?
" Day 22 baby up to 7#14oz, day 24 8#3oz."
That's more than okay, even on conservative interpretations of what a baby
should be doing....now's the time to reduce the supps, the pumping and the
interventions.
Yes, Anne, I agree - judging milk production by amount pumped is very
misleading.
Heather Welford Neil
NCT bfc Newcastle upon Tyne
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