Anne wrote: 

I am not aware of any tests that have been done on the baby, but I would =
think some are=20
warranted now. Formula isn't going to cure whatever is causing his weight=
 gain problems=20
- and the thought of what it might introduce to his system is frightening=
...

Anne, 

If mom's supply is too low, and baby is not gaining properly, then an artificial baby milk must be used if nothing human if available. Formula certainly will cure his weight gain problems if mom's supply is too low!!! It will add calories and baby will gain weight. 

Now, I dislike formula also, but I would hate more to force slow gaining babies to continue their lack of calories if this is the cause of the poor weight gain. That is more cruel than giving formula. A person or baby who is not eating enough feels miserable. It would be unethical for an IBCLC not to advise a mother to feed baby enough by whatever method it takes if this baby is not gaining weight properly and just breastfeeding is not making him gain weight. 

I'd like to see some test weights with an appropriate scale on a feeding or two. Perhaps intake is fine and baby is just slow to grow. Perhaps intake is poor and baby is starving. 

Dr. Smylie and Laurie Wheeler already addressed the other issues. 

I am also dismayed at this trend to blame mom's possible/potential hormonal problems for poor weight gain when test weights with an appropriate scale have not been done, no one has seen the baby to address proper latch on, possible tongue tie, oral motor problems, etc. When no one has sat and watched the nursing session, and done test weights through an entire feeding, it can be impossible to guess what is going on. 

I have seen so many problems that moms describe totally differently on the phone. Email consultations are very problematic as you do not know what is really going on because you can not see mom or the baby in person. I have worked with many many starving babies and one of these was one that mom swore was having issues with food allergies. The real reason he cried all the time was poor intake and starvation. 

The slow return to birth weight is a big red flag. If baby did not nurse well in the first week, because baby came early and was sleepy due to the pain medicine from the epidural, mom's milk supply may not have been stimulated enough to establish a full supply of milk producing cells unless she was removing milk another way. What happens sometimes is mom has enough for the early days but when baby starts needing more per feeding, then the baby stops gaining weight. 

I did not read your email and do the math for myself, I take what Laurie said and assume the weight gain is just somewhat slow to normal. But if mom feels something is not right, then she needs a full lactation consultation with test weights and someone who knows how to read baby's breastfeeding language. 

Kathy Eng, BSW, IBCLC

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