How were the diapers 24 hrs before your consult and the next diapers after?
(obviously not reliable if she was supplementing during that time)
Did mother notice, or did you palpate, any breast softening resulting from
the feed? With 10 min of obvious swallowing, one would expect a change in
density of the breast(s). 
Sometimes the difference is visible: convex to level or level to concave,
and different from the other, non-nursed breast.
Wish we had a handy portable economy-sized U.S. machine in every Prvt Prac
office so we could "see" what is really happening in these puzzling
situations.
Maybe a clue can come from mother's expectations: her prior experience
defines her ability in her own mind, regardless of how competent her
advisor is. Details behind that prior lactation failure can be helpful.
Just some thoughts, FWIW.

Phyllis Adamson, IBCLC, RLC
Glendale, AZ
[log in to unmask]

 
   The other day I had one of these...a 3-day-old who appeared to 
> be gulping and swallowing for most of 10 minutes, and had transferred
only 2 
> cc.  The mother's breasts were feeling full, and based on visual clues 
> alone, I would have said her milk was coming in and she could go home and 
> nurse ad lib, even tho the baby was 9% below birthweight at less than 72 
> hours of age.  Instead, she began pumping and supplementing.  (In part,
also 
> because she has a history of prior lactation failure)
>
> I don't know what these kids swallow...must be their own saliva...or 
> extremely small "boluses" of milk?
>
> Kathy Leeper, MD, IBCLC 
 

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