I have seen situations similar to this. Usually it is a case of
breastfeeding being poorly managed from the start, and "catching up" with
the mother and baby eventually.

The babies I have worked with with this sitation were taking in an
inappropriately large amount of solids too early, were depending on
supplements, when it was perhaps possible to feed the baby directly from
the breast at all feedings, had unusual breastfeeding patterns ("three
minutes" at the breast is not a regular feeding for most babies at most
feedings, most women find this not enough to continue supply)
sleeping "through the night" and other things which always made me
think, "It is a wonder we didn't see more problems earlier!"

There was no mention in your post of exactly how many diapers, the state of
the child's stool (although with all that cereal, it might not tell us
much) and the baby's current weight with her weight hx.

In situations like this I encourage the mother to nurse nurse nurse. Take
the baby into her bed to encourage and facilitate night time nursings and I
encorage reducing the huge amount of solids, which in most cases are
interfering with milk intake, as well as nutritent absorpson, and keep good
diaper and weighing records. I also encourage these mothers to attend La
Leche League so they can "normalize" their breastfeeding experience.

The way this baby is nursing NOW is what I would consider regular and
normal for a baby this age!

Breasts feeling "soft" has no correlation to milk supply, and the mother
may want to count and qualify diapers per 24 period instead of guessing.

Does she have a WAB or a connection to a LLL group? As this baby appears to
be attempting to normalize her own breastfeeding and milk intake, the
mother will need the support to allow this to happen.

Of course keeping an eye on, but not getting to hung up on, weight gain
will be helpful.

I have worked with mothers in these cases who managed to eliminate or
greatly reduce the solids,(gestationally speaking, this baby is only 16
weeks old, too young for solids at alll, according to many) work on
normalized breastfeeding patterns, increase night time nursings, and all
had supplies which were all the baby needed. The babies were happier, too.

A referal to a good IBCLC would also help this mother overcome the rough
start they have gotten off to.

Mary Jozwiak IBCLC, RLC, LLLL, AAPL
Private Practice

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