Leslie:  I'm not quite sure you have a problem here.  Baby is now about 6 
months old?  Weight gain does tend to slow a bit, especially in the 2nd 
half of the 1st year.  Is baby continuing to meet (or exceed) developmental 
milestones?  That, to me, is  a little more important than weight gain 
numbers.  If the doctor expects this baby to continue to gain an ounce/day, 
that expectation is way out of line.  Gaining 60% of what the baby had 
been?  Doesn't necessarily indicate a problem to me. Remember, too, baby is 
becoming more physically active and therefore burning more calories.
Can the mom start solids at 6 months?  That should help.  My instinct is to 
tell her to lose the pump - it's my overwhelming experience that pumping is 
a huge stressor on a mother and the struggle to find time to pump, as well 
as nurse the baby, as well as run a household and care for other children, 
as well as possibly work outside the home, as well as try to find time for 
self-care is huge.  I'm exhausted just listing what for most mothers is her 
daily life!  She may also want to lose the galactogogues, as again, in this 
situation I get the gut feeling this is just reinforcing in her mind that 
she is a failure in not being able to keep up with baby's supposed needs.  
The emphasis should be on nursing and mothering her baby.
These are just my opinions, not having a complete history or having seen 
the baby myself.  Hopefully some of the suggestions you've received will 
help this mother and baby.  Good Luck.

Pam Hirsch, RN,BSN,CLC
Clinical Lead, Lactation Services
Advocate Good Shepherd Hospital
Barrington, IL   USA

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