Donna,

These are my general guidelines for healthy full-term, fully breastfed
(without any supplementing with water or formula) infants:

First 24 hours:  one wet diaper and one tarry stool

Second 24 hours:  two wet diapers and two blackish stools

Third 24 hours:  three wet diapers and two greenish stools

Fourth 24 hours:  four wet diapers and three stools--hopefully yellow by now

Fifth 24 hours:  five wet diapers and three yellow stools

Sixth 24 hours:  six wet diapers and three to four yellow stools

These are the minimums.  If the minimums aren't met, I look for the reason:
Is the baby jaudiced and/or sleepy?
Are the mother's nipples sore?
How frequently is the baby breastfeeding?  "On demand" is not a satisfactory
answer as some babies are truly content to starve.
Are the feedings limited to a certain number of minutes?
Has the "milk come in"?
Were any drugs or interventions used during labor and delivery?
Did the mother experience any breast changes during pregnancy?
Was the baby born at <37 weeks?
Does the baby weigh less than six pounds?
Has the mother had any breast surgeries?
Is the mother or baby taking any medications?

I could go on and on with possible questions.  IMHO, if a the output isn't as
expected, the LC should become involved.  I disagree strongly with the advice
to breastfeed and follow with formula. Giving a bottle of formula doesn't
solve the problem.  If the output is low, the intake is probably also low,
and that's what needs to be fixed.  Adequate milk transfer, for some reason,
is not taking place.

I believe telling a mother to give a bottle of formula undermines her goal of
breastfeeding this baby.  The baby will not want to breastfeed as soon and
consequently the breasts will not get the stimulation that the next feeding
would provide.  It tells the mother than something is wrong--either with her
breasts or with her baby.  It promotes bottlefeeding, which could cause a
whole other constellation of problems.  It promotes the use of formula, which
is inferior to breastmilk.  It can provide the sensitizing dose of cow's milk
protein and contribute to the risk of allergies in the future.

The LC should be called if the baby is not having enough wet and soiled
diapers.  He/she can evaluate the mother/baby pair and make the appropriate
recommendations.  It may be as simple as a change in positioning or latch-on
technique, increasing the number of feeds or increasing the stimulation to
the breasts.  A bottle of formula wouldn't address any of these issues.

Elizabeth Puzar, IBCLC