Always be kind and respectful.
Language and counseling skills are critical here. You need to explore 
why the mother doesn't understand her baby needs more food. Maybe she 
just wants to breastfeed so much. Maybe she is scared of formula so 
using banked milk or other donor milk would help. Maybe she truly 
doesn't see that anything is wrong.
I love the way Laurie uses the word "calories". The baby needs more 
calories, not you need to feed the baby more, you need to supplement.
You can talk about the extra calories needed as a transitional tool that 
will help her get where she wants to go. I do sometimes talk about we 
need to go backward in breastfeeding to move forward in breastfeeding.
Also, you could try to just present the evidence in a factual way. Human 
babies gain on average about .5-2 oz per 24 hours. 0.5 is really the 
minimum. Let's look at your baby's weight starting from day 4 or so, 
where we would expect the baby's lowest weight to be. Just go through 
the numbers. My guess is that your mother will come to the same 
conclusion that we all have! That baby needs more calories NOW. Please 
have her do pre and post weights.
Or better yet, you do one. After the baby feeds, before you put the baby 
on the scale, ask how was that feed? Terrible, ok, or great? If the 
mother says great and then the scale does not reflect that, it is more 
evidence. Let her know how many ozish the baby needs in 24 hours based 
upon her weight. Calculate that out for her. Take the number of feeds in 
24 hours and multiply that by the transfer understanding this is just a 
rough estimate. If I am concerned about weight gain this number, no 
matter how generous I am being with transfer, is still far lower than it 
needs to be. A note though, I found when babies have not gotten all the 
necessary calories for a number of weeks, they need to eat far more than 
the roughtly 2.5 oz per pound per 24 hours after day 10.
On a side note, I am fostering tiny baby kittens and weighing them every 
day. Baby kittens put on about .5 oz per 24 hours. When I first get them 
they are usually quite thin and eat like pigs for 2-4 days. Then they 
settle down with their intake. Watching their weight everyday has shown 
me what great variation there are as to how they put on their weight. 
Some days they lose weight, other days they put on 2.3 oz.
Back to the issue, the mother says she has lots of milk but either her 
baby has a serious health problem or the baby is not drinking the 
plentiful supply.
Thank you,
-- Barbara Robertson, MA, IBCLC, RLC The Breastfeeding Center of Ann 
Arbor bfcaa.com

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