Mary, It sounds like this kid may be underfeeding. Some folks don't like to
use feeding weights. In this case, it could provide valuable info. Weigh
baby on digital scale, bf, then weigh again, in same clothes and diaper. If
it's a scale made for "test" weights, it will give you a gram change which
approximates closely the milliliter intake. Of course, there is no magic
number that the baby should be taking, but for a 3 wk old, large baby, if
the intake is pretty low, you will get a good idea he is underfeeding.
As per some recent posts, these babies often do well if they are
supplemented (with mother's own milk when possible) until they get to where
they "should" weigh if they had been gaining well from the beginning. A
couple of options would be 1. to use MOM in a nursing supplementer at
breast. The flow will likely keep him nursing longer. 2. Paced bottle
feeding with slow flow nipple, again using MOM if possible. 3. Switch
nursing with breast compression - this may not be enough at this point.
Perhaps since baby had a somewhat traumatic birth, and parents had a
stressful hospital experience, with blows to their confidence, that bf did
not get off on the best foot. I worry at this point that mom's supply will
start to downregulate, so maintaining abundant supply is critical.
Laurie Wheeler RN MN IBCLC
Mississippi USA

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