That baby needs to be seen by a ped - pronto! She is not transferring milk
at the breast and needs to be supplemented. With the weight loss you
mention, was the baby weighed naked at the peds office? Sounds like baby was
desperate as opposed to alert. This is bothering you because it does need to
be taken care of.

Gail S. Hertz MD, IBCLC
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Lynn writes
> The baby in question was delivered at 8-2, dropped to 7-6 before milk came
in
> (late, on day 6), rebounded up to 7-10 by day 20 but by day 26 (our
consult)
> had dropped back to 6-6, a loss of 20 oz in 6 days!! The baby was seen
twice
> by pedi (between day 8--20) with <1/2oz/day wt gain (on different scales)
and
> was not scheduled for a f/u for 2 weeks. Fortunately Mom called our
*warmline*
> for direction after baby had not stooled for 12 days (3 days after last
pedi
> apt) and they scheduled f/u with us. On exam the baby appeared cachectic
but
> voracious at the breast-practically inhaled it, thus she was alert and
active!
> We did supplement during the consult BUT I was worried about them after
they
> went home.....do we rely totally on the baby's clinical status (ie. alert
and
> willing to eat) to determine whether closer monitoring is needed or is
there a
> marker for wt. loss that should signal further w/u.... regardless of
baby's
> ability to eat?   I did (of course) call the pedi with the details. I
assume that
> this type of scenario is not as uncommon as we would hope.

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