I met a mom at WIC clinic yesterday who I had never worked with
before.  Her baby is abt 3 wks old and she has been struggling with feeding
issues since the beginning.  There are so many pieces to this story, it is
difficult to determine which issues are most important or even what to
address first.
        The baby seems to have a good latch.  Concerns arose that he had not
regained his birthweight by his two-wk checkup.  Nurses (I don't knoew which
ones or when)  urged continuing BF and adamantly told the mom NO FORMULA.
Ped. said it was up to the mom. (second hand info.).  Mom was scared
silly--first baby, scared of dehydration, overbearing neighbor pushing
formula and she decided to "top off" each feeding with formula.
        This had been going on for a week and here's where I come in.  Now
mom reports ten BF sessions per day.  She then waits to see if baby seems
satisfied.  He inevitably begins to cry.  She checks diaper, offers comfort
or pacifier.  If nothing helps she offers a bottle of formula.  This usually
does the trick.  But when I added the amt. of formula she offered in one
day, I came up with 60 oz!
        Now everyone (except the neighbor) is telling her to cut down on the
amount of formula.  She agrees, but only if the baby seems comfortable with
that.  Other facts:  If mom pumps (small, elec, non-cycling, one-sided
pump), she will collect about 1oz (both sides combined).  If she pumps after
feeding, she gets abt 1/2 oz.
        Mom has had diarhea since giving birth.
        Left nipple is flat
        Baby does't like nursing on left side.
        Lots of allergies/asthma in family--mom seems pretty committed to
          continuing to BF.
        Baby's weight is good now  (better be after all that formula).
        Mom says she's really stressed about everything and wants to be
         treated very "gently"

        I am attempting to get her a hospital-grade double pump.  She seems
to be receptive to this.  The issue I'm attacking first is overall supply.
I'm going to suggest lots of alone time, skin to skin, etc.  Also, I was
concerned about HER health.  I told her to call her doc. about her health
issues.  If she is dehydrated, her supply may be low.
        WHAT NEXT!  Ideas anyone?  Have I missed anything?
                Brenda