Hi Esther,
First month was good as far as wt gain, but at 2 months old, when baby
had gained 1 pound in 1 month, that should have been a referral for bf
help. At 3.5 mos when fussiness and spitting started, I am not sure if
this is reflux or milk allergy, but fussiness is associated with
hunger in my experience.

I agree with you, I would think that milk allergy would have
manifested itself sooner. And I am not sure if this is oversupply or
overactive MER but at this point with all of the supplementation and I
assume bottle feeding, I would not expect that baby is dealing with
oversupply. Since baby recently transferred over 2 oz milk, it doesn't
seem mik supply is the issue with low gain, although I am certain that
all of this has caused a decrease in supply.

I am not sure what is going on, but that the mother and baby should be
supported in trying to figure this out and resume full bf. It seems
frequent wt checks would be indicated, baby gained 6.6 oz in 9 days
with ebm and powdered formula. The powdered scoop I don't think adds
that many calories to tip the scale that much, but I am assuming mom
pumps and bottle feeds it, so the point is that baby must not have
been getting enough breastmilk previously, when bf directly.

I would be trying to sort out the bf practices (feeding very often,
feeding at night, no pacifier, responding to all cues) and finding the
most comfortable positions for mom/baby, and following for wt checks.
You will have to have the support of the dr. and be able to reassure
him that you are concerned about the wt, and will follow very closely,
and provide all the info that her milk itself is fine and rich (some
hcps still worry if moms milk is 'weak') and that you have evaluated
her supply to be adequate. I would also reassure the dr that I would
recommend formula if needed and that I was not dead set against it.
Sometimes it helps to really convey to the dr that mother is very keen
to continue bf and wants to work more on it. They don't always get
that message strongly from the mom.

Hope I was of some help.
Laurie Wheeler RN MN IBCLC
Mississippi USA

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome