The health visitor has probably seen many babies who have not regained
birthweight by 21 days continue to be very poor feeders due to lack of
energy.  Her suggestions about supplementation are not entirely crazy, but I
disagree with her recommendations about discontinuing pumping.  I would
suggest you pump your breasts for 10 min. after you breastfeed and feed all
the pumped milk back to your baby immediately.  You may want to offer the
baby a bit of pumped milk or even formula at the START of each breastfeed to
get the baby's eyes open and energy level up a bit.  Use deep breast massage
while the baby is latched -- esp. if the baby closes his or her eyes.  If
the baby goes to sleep, he or she may be at breast but is prob. no longer
dining.  Wake the baby up by switching breasts and massaging more.  When
nothing you do succeeds in waking baby or keeping baby swallowing, stop,
pump and feed that to the baby.  If you don't get much milk, some formula
for a few days will assist baby in getting strong enough to really milk the
breasts better.  It can be difficult with 3 little ones to find time to help
a smallish baby, but this long without recovery of birth weight can be rough
on the baby.  The weight checks are not an occasion for you to feel as if
you have failed, but an opportunity to have  a look at whether your feeding
plan is working to help the baby recover.  It is a chance to give you the
feedback you need to solve your problem.

Barbara Wilson-Clay BSEd, IBCLC
Austin Lactation Associates
http://www.lactnews.com

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