I just read Kathy's posting on lactnet about the need to supplement
when breastfeeding is not working and couldn't agree with her more. I
agree with Barbara Wilson Clay's approach and have found that it works!
When fixing the breastfeeding problem does not result in robust weight
gain we MUST meet this baby's hunger needs. I recently saw a baby who at
7 days had lost 20% of its birthweight. Even taking into account some
overhydration due to pushed IV fluids during labor, this was too much to
lose. This baby had not stooled in 5 days and was having only brick
stained diapers at 7 days. Baby latched and fell asleep with periodic
sucking. The mother thought that this was breastfeeding because he
stayed on all day. With supplementing, pumping, and improved latch, this
little guy gained 10oz. in a little less than 48 hours. He is now
actively nursing at the breast and being supplemented with pumped
breastmilk which will be gradually reduced.
We cannot ignore a baby's metobolic needs for fluids and calories while
we are waiting for breastfeeding to work and no baby should have hunger
needs go unmet. The bottom line is that I have found that this approach
works to save breastfeeding.

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