Hello, Dr. Jennifer.
       There is nothing scientific to what I'm going to post here--it's just
based on years of experience.  There are babies who are exceptions, but I
generally find that babies frequently have some difficulty with breastfeeding
until they are *both* 6 to 6 1/2 lbs in weight and 39-40 weeks.  In other words, a
6-lb. 37-weeker and a 5 lb. baby who has reached due date, may each still
have trouble with the coordination and/or stamina needed to breastfeed without
supplementation.  They get more and more efficient as they gain maturity and
muscle mass.  I often find that moms have more confidence when they have this
tangible goal, rather than just a vague "eventually" he'll do better.   And this
also lets moms know that if baby has *not* accomplished exclusive
breastfeeding by the time both of these parameters have been met, it's time to ask for
more breastfeeding help, so these moms and babies don't just go on struggling and
eventually fall through the cracks and give up.
       I suggest encouraging this mother that chances are good that her baby
will figure this out in time (though of course no promises can be given), and
suggesting stategies that will help baby learn more efficient breastfeeding
technique while he is being bottle-fed the necessary supplement.
       Dee

Dee Kassing, BS, MLS, IBCLC
Collinsville, Illinois, in central USA

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