Thanks to Kathy Bruce for doing the math.  4 oz of gain per week sounds
perfectly fine to me too--and it fits LLL's guidelines of 4-7 oz per week.

My concern is the assumption that the kid needs to take both sides and get
more milk.  She started out dealing with oversupply, right?  And she's
clearly giving the signals that small frequent feeds are more comfortable for
her.  So why would we try to squeeze more volume into her?

On the other hand, breast compression sounds like a winner.  If she gets
another 5 cc of cream at the end of a feed, that'll maximize her caloric
intake without over-filling her little tum.

She's taking 11 feeds per 24 hours (q 2 with one 4 hr stretch).  If we made
the assumption that the test-weighing done by the LC was an average feed
(even though we'd probably be mistaken to do so!), that would be 11 x 2.5 =
27.5 oz (or 11 x 75 ml = 825 ml) in a day--a high-normal intake for a 9
week-old, and really a lot for a petite 9-week old.

Maybe the test-weight was bigger than her usual feed.  Maybe she averages 2
oz per feed.  That's still 22 oz per day, not bad for a petite 9-weeker.  I
rented a pump once to a mom whose baby didn't latch on; the mom pumped for a
year.  The baby took 19 oz a day.  Mom could pump more, but the baby wouldn't
eat more.  At the end of the year, I picked up the pump, and there was the
baby, zooming around the house, chasing the family dog, a little bullet built
for speed.

You know, somebody has to be on the bottom half of the weight chart to push
all those little Sumo wrestlers up to the top half!

The doctor has an interesting take on the REM sleep, but I bet he's just
whistling in the dark.  Good thing he's not practicing with the !Kung mothers
whose babies nurse 1-2 minutes 3 or 4 times an hour--or with Diane
Wiessinger's second-born, who did the same.

And Mike Woolridge found that feeding at shorter intervals gives the baby
higher-calorie milk.  It sounds as if the baby has worked things out well for
herself, and the grownups want to "fix" something that ain't broke!

As for mom going to work, that is a problem that baby has no inkling of, and
she couldn't change in anticipation even if she did know what her mom is
planning.  My suggestion for the mom is to put her energy into finding a
caregiver who will understand that her baby is an individual and help the
baby make the adjustment to separation in whatever way the baby has to do it.
 If she ends up eating 2 oz q 2 hours with the caregiver, so be it!  That
would be the time for mom to attempt some lactoengineering.  She could set
aside the first ounce of pumped milk and put the rest in a bottle for the
caregiver.  Maybe that would help the baby "last" longer between
feeds---which is the main concern for a caregiver, right?

As long as the baby is healthy, why mess with her?

Chris Mulford
Eastern USA

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