Hi Ilene,
My main question would be did mother have a very good and *noticeable* milk
surge, that lasted more than a couple hours? In my experience, many mothers
with low milk production have a very short milk surge, but mothers who do
well with milk production have a day or two of "engorgement" (not
pathological).
I agree with the others who posted that baby had reached his low point since
hospital discharge and is now gaining weight. He's only 5 days old so
nothing is too worrisome at this point. I would be concerned, however, with
a baby who had lost close to 10 percent with early and unrestricted bf. It's
easier to do in grams, but by my calculations baby lost 13 oz out of 135
total oz (b.wt), which is 9.6% to be exact.
I am not convinced of the inflated birthweight theory due to maternal IV
fluids.
Therefore, if this were a mom/baby dyad I was working with, I would first
just review the usual good bf management things, as I am sure they are
doing. Good latch, unrestricted access, and waking the baby if sleepy to
ensure frequent feeds the first week or so. I don't think breast compression
is a bad idea for times when the baby is acting too sleepy, but I agree it
is not a necessary thing for most moms. I would schedule a weight check in
48 hrs.  I would not do ac/pc wts, I can't remember last time I did that. I
would look for tongue-tie, just a quickie visual, nothing invasive at this
point.
I predict they will do fine.
Laurie Wheeler RN MN IBCLC
Mississippi USA

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