Seeking advice with permission to post...
   
  Baby will be seven weeks tomorrow.  Birth weight via fish scale was 9 pounds.  Lowest weight on day four, was 8 pounds, 10 ounces using clinic scale.   Birth weight was regained in just over two weeks and has increased with every subsequent recheck, but rather slowly.  We are averaging four ounces, with some just shy and some just over, each week.  For interest, I did a twenty-four hour check this week, which showed only a 5 gram weight gain.
   
  Baby is thriving - alert, appropriate tone and active.  He nurses on demand, without restriction and cosleeps.  Feedings vary, with cluster feeding in the evening and longer sessions at night (no longer than one four hour session).  He has between ten and twelve breastfeedings sessions each twenty-four hour period and is quite content with each feeding.  He has sufficient pees and two large yellow-seedy poops in the morning, with several smaller poopies throughout the day.
   
  This is mom's fourth baby with a successful breastfeeding to 18 months, exclusively.  First experience failed due to lack of knowledge and hospital supplementation.  Her third attempt failed due to prematurity, loss of supply and lack of support.  
   
  Mom is tiny and was a slow gainer herself.  No pacifiers, nipple shields or supplementation is provided.  Mom is not on any medication, besides Metamucil, including birth control, and does not smoke.  No history of hypertension, thyroid disorder, diabetes, hemorrhage, or depression.
   
  Latch, such, and swallow are optimal with no tenderness or breakdown of nipples, and gulping is easily observed with let-down.  
   
  Maternal nutrition is optimal, although we have explored adding additional healthy fats to her diet.
   
  This couple was refered to me by baby's exceptionally supportive physician just over a week ago and I have had the opportunity to meet with them several times, including observing them with siblings in a breastfeeding support group.  This family appears to have optimal dynamics and mom is exceptionally attentive to baby.
   
  My suggestions haven't offered much success and I was hoping your collective wisdom might shed some light on this couple's situation.  Most importantly, how long can I watch slow growth?  Where do we draw the line?
   
  Very Gratefully, Penny Lane
   
   
   
   


Penny Lane RN, IBCLC
Maternal & Child Health: Lactation Consulting
Believe - Birth & Breastfeeding Resources
 
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