I'll say this carefully as I don't want to field a bunch of questions/flames
regarding why we should ever have to supplement an infant.  But -- that said
-- what I'd like to know is if there is any particular standard upon which
LCs determine a baby w/ FTT needs to be supplemented.  For example, let's
assume a baby of 21 days of age who was 8# at birth, and now at 21 days is
7-8.   Based on mom's assessed milk supply through ac/pc weights and making
sure baby is latched well, mom using breast compression yada yada, you have
determined the baby needs to be supplemented.  The question is (not the
substance with which you are supplementing) but how you determine how much
the baby needs.

Do you use:  120 kcal/kg/body weight/24 hours?
108 kcal/kg/body weight/24 hours?
Number of pounds baby weighs times 2.5 for a 24 hour volume need?
Number of pounds baby weighs time 3 for a 24 hour volume need?
Weight of baby in ounces divided by 6 for a 24 hour volume need?

And next question:  Let's take our mythical baby who was 8# at birth, and at
21 days is 7-8.  Do you determine what the baby "should" weigh starting at 8#
birth weight and adding an ounce a day coming up with a 'should' weight of
9-5, or do you start at say 10 days, assuming baby should be *back* to birth
weight by that time, and then add an ounce a day -- meaning the baby by now
should be 8-11.  And do you figure your supplementation needs based on those
figures?  Or some other way?  Or -- supplement w/ whatever the baby will
take, and I'll see you back in 3 days?

How do you work w/ a baby that is FTT that needs supplementation for a period
of time?

Jan Barger, RN, MA, IBCLC -- Wheaton IL
Lactation Education Consultants
www.lactationeducationconsultants.com

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