Dear Jacqui Gruttadauria,
I am normally just a viewer on Lactnet but felt compelled to respond to
your friend of a friend's situation.
I may very well offer suggestions that you have already tried, or
information you already know. I apologize.

I too have never heard the "lack of protein" the cause of an infant's not
gaining weight adequately. I do believe that something is going on with
this infant, if I'm understanding things correctly.

What was the baby's birth weight? What is the infant's medical
history...mom's?

Standard growth expectations are...1/2 oz to 1 oz a day until
approximately 4 months then about 1 lb
a month. Baby should have doubled her birth wieght by 6 months of age.
After the fourth or fifth day of life there shouldn't have been any weight
loss.

I suspect the mom's milk supply isn't as much as she thinks.It may have
been in the beginning but surely has been affected by now. Also, I don't
think just finishing the first breast first will help at this point. I'm
also concerned about the "long nursing" sessions...an hour...this also
tells me the baby isn't getting as much milk as mom thinks.

Sometimes it has nothing to do with mother's ability to make milk but the
effectiveness of the baby nursing. Even now that the baby is older. I have
seen a couple of babies who have gained weight well in the beginning,when
the milk supply is abundant, but when the milk supply is driven by the
baby it begins to slow down. At this time it is determined that the babies
have an underlying problem, most often an inadequate suck.

My first intervention would be to have mom rent the Baby Weigh scales from
Medela, teach her how to perform pre and post feed weights. If intake is
less than adequate then begin supplementing. If the baby is over 6 months
of age then solids might be enough. If I understood correctly the baby got
4 oz. of sweet potato in one day. If just starting solids, then I feel she
needs to be on a "fast track" for a more varied diet...one high in protein
and fat. Also, always breastfeed before feeding the solid food. In the
meantime, mom needs to begin pumping to increase her milk supply. She can
feed "hindmilk" by cup.

Also, the baby has some "catching up" to do; therefore the weight gain
should (in the beginning) be in excess of what is expected for a normal
thriving infant.

It is a shame the doctor knows so little about human milk that he/she
couldn't help to "fix" the breastfeeding and keep mom's self-esteem in
tack.

I hope this helps. I'm not sure there is a quick fix for breastfeeding,
but feel there needs to be a quick fix to the weight gain issue...if I
understood a weight loss and then just a few ounces a month.

Good luck to mom, baby and you.


Camille Foretich, BS, IBCLC, CHES
Lactation Consultant/OB Educator

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