Liane, I'm very glad to hear that the mother is being referred to (I hope) a 
better doctor.

I don't rely a lot on better and after weighing, either, but in your 
situation that's kind of all you have. I use the standard "rule of thumb" to 
calculate the amounts of milk a baby should get of 2.5 to 2.7 ounces per 
pound of the baby's weight. But, for a baby who is well below the expected 
weight, I would expect a higher amount so baby can catch up. Of course, the 
number of feedings per day matters as well. If the mother is feeding about 
10 times a day, 2 ounces per feeding, the baby is only getting 20 ounces a 
day. An 8 lb 6 oz baby would need about 23-24 ounces per day. BUT since this 
baby is so much below birthweight, I'd want to see it getting more like 3 
ounces per feeding, for a total of 30 ounces per day, so that he can catch 
up. In other words, I'd want him to be taking in an amount that is closer to 
what he'd be supposed to get if he was at the weight we expect him to be at 
this age.

I'd also just like to add that, in my experience, many mothers are not 
always good at telling if a baby is vigorous or doing well when the baby is 
not getting enough milk. I don't know why this is, but over the years I've 
had many mothers who have told me "my baby is doing well, he looks great, 
he's active, feeds well, etc., but for some reason he's not gaining weight." 
Or maybe they haven't even had the weight checked at this point but want to 
see me for some other reason (maybe no or infrequent stools, sore nipples, 
etc.). Then when I see the baby, I'm shocked. The baby is clearly NOT doing 
well - looks thin, worried, may be dehydrated, etc. Signs I can see in just 
looking at the baby for a few seconds. But the mothers thought all was fine.

I'm usually an advocate of "mothers know their babies best" but in this one 
area it seems mothers do sometimes misread the signs. I'm not sure why, but 
I've seen it now too many times to just accept a mother who assures me that 
her baby is looking great, active, etc.

Teresa 

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