Karen, Baby is 6 wks old and has lost 8 oz - I would consider this a medical emergency. The first thing I would do would be to be very very generous with the feedings. On babies that are losing, I find, once the supplement is liberalized, they gain 4 or 5 oz in a day or two. If mother prefers donor milk, she can use from her source or try to obtain from a milk bank (dr could order it). I would not think it was retained placenta if milk came in on day 5 (how fully did it come in - most moms are quite full). The risk factors are the 35 wks gestation and I suspect baby was sub-optimally draining the breasts. The high bili of 17 indicates starvation jaundice, unless there was some pathology like blood type incompatibility, bruising, etc. It would not be a mommy problem if she had lactogenesis II in my opinion. the supply would be low now due to the baby not milking the breasts well and I'm guessing mom did not start out expressing extra for him. If liberalizing the feeds doesn't work immediately in 24-48 hrs, then the baby needs to be worked up. Maybe cardiac, sepsis, metabolic, or some developmental delay. Any oral anatomical variations? The mother should kangaroo care and feed the baby whenever he peeps, any stirring or rooting whatsoever. I would try to feed him every hour or two. I calculate he needs 15 oz per 24 hrs or more. Is he taking that? Does he have any trouble taking the milk. Use the supply line at breast if he has a good latch and suction, if not, use a bottle would be my recommendation at this point. As far as the organic formula, is it homemade? What is the calorie count of it.? Karen, I don't know when you began helping this mom, but I'm saying this next bit for the benefit of anyone to the arena of breastfeeding work: do not let this lack of wt gain go for more than a few days. If baby is not gaining by day 4 or 5, I get very worried and start interventions. Then f/u in 24 - 48 hrs. Hope this baby turns around soon. Laurie Wheeler RN MN IBCLC RLC new orleans louisiana USA _________________________________________________________________ On the road to retirement? Check out MSN Life Events for advice on how to get there! http://lifeevents.msn.com/category.aspx?cid=Retirement *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html