Re your case study:
Several things are possible:
The initial wt loss is excessive to me. What was the reason? Poor bf from
the beginning and/or delayed/low milk supply? I bet the baby had history of
jaundice too. Should have been followed and corrected early. Too bad this
was not done. You never know sometimes you find out that mom had a breast
reduction surgery in between last baby and this one. The LC has to ask all
these questions.
The lack of wt gain is extremely worrisome. What someone has to do is
determine if milk/calories are going in but not putting wt on the baby i.e.
heart defect, infection, ??? OR
Or more likely the baby is not taking in adequate amts. This could be result
of poor early feeding, low milk production, and now at 5 wks very
compromised supply. The 5-10 minutes of bf every 1.5 to 2 hrs SOUNDS good,
doesn't it, and could very well be for a robust thriving 5 wk old who is
extracting large amts of milk quickly. But like Jack says 24 hrs of
"pretending to bf" will not put wt. on the baby. So is the baby really
EFFECTIVELY breastfeeding????
The urine and stools are low for this age and probably have been so all
along. I like to see MINIMUM 6 heavy wet diapers and MINIMUM 4 messy yellow
seedy poops (teaspoon or tablespoon size to even count them) per 24 hrs by
day 4-5.  I would get a detailed history and physical exam of mother and
baby and I would of course observe feeding and do a milk transfer also
called pre and post feed wts. See archives for much discussion on the value
of this or not. I would guess that supply is very compromised and so baby
would need to be fed generously at this point (donor milk or artificial baby
milk) until mother can relactate. This could take intense efforts at this
stage of the game. I agree the pacifier has to go and ask if the mom is
giving water or anything else. She could use a nursing supplementer to give
the milk.
You know alot more than you thought you did and you are right to be very
concerned for this dyad. I hope you never stop learning, teaching, and
helping.

Laurie Wheeler, RN, MN, IBCLC
Violet Louisiana, s.e. USA

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