Jay writes: Other than that, I cannot recall ONE SINGLE BABY whose slow
weight gain was the ONLY sign of a serious disease or problem.  In other
words, with good
follow-up and lactation consultation and reassurance from a few simple tests,
slow gaining babies can be watched and helped.  They rarely need
supplementation via SNS but this can help a few babies.

I think I'm confused. Were these babies gaining slowly, then, because they
simply were not getting enough to eat? How were you able, then, to rectify
the situation with a 6 week old infant without supplementation? Certainly
many breastfeeding problems can be solved with improved breastfeeding
management, but I've seen too many situations where mother was doing
everything "right" but baby was not getting enough to eat...either mom had
low milk supply or infant was unable to transfer sufficient milk. I think it
was Barbara Wilson Clay who stated that robust wt. gain is the norm.  We
don't have to sacrifice breastfeeding  on the alter of growth charts without
taking genetic background, developmental milestones, etc. into consideration,
but I would never be comfortable with a baby below birth wt. at 2 or 6 weeks
unless that pattern were rapidly turning around with robust wt. gain, and
sometimes  it just can't be done without supplementation. I also strongly
believe that we are not being fair when we leave a baby with her hunger needs
unmet. When improved bf management does not result in appropriate wt. gain
then we need to supplement and see if the baby will gain when receiving
adequate intake.  Exactly what appropriate wt. gain is is another story, but
we do need some bottom line. If the baby is gaining 1/2 oz. per day and is
happy and developing normally I find that acceptable. If the baby is gaining
1/2 oz. per day and is NEVER satisfied then I don't find it acceptable. When
everything we've tried at the breast doesn't fix it, then the baby needs more
to eat.

Kathy Boggs, RN, IBCLC
waiting for the flames in Mtn. View, CA

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html