Mary and everyone,
Here are some questions I'd be thinking about if I were there to assess the
baby breastfeeding:

1. WHY NO POOP IN 4 DAYS?  wet diapers 6-8 ? very wet... or sort of wet?
This makes me think that baby is getting enough to be hydrated but not
enough for good nutrition/growth.  I have gone as far as to have mom save
diapers for me - bring the diapers with the baby for a visit - it's amazing
the range "wet" is to people.

2. Is the weight accurate?  Different  scales give different stories -- the
wt gain is at least 5 oz in 4-5 days if 1  oz below birth wt   BUT IF 1 oz
below DISCHARGE WT this is minimal gain assuming baby dropped further after
discharge.  I would bring baby back in 24 hrs for wt check on same scale.

3. How often and how much milk?  If I'm hearing 6-8 diaper changes that
means 6-8 feeds - my gut (and the workings of baby's gut-see question 1.)
tells me this is not enough.  20 mins a side doesn't sound awful, but how
much of that time is baby "actively feeding"?  If baby only sucks here and
there then that's not 20 minutes worth of "restaurant time" -- it's 20
minutes of cuddle time and maybe 5 minutes or less of restaurant time.

4. Is baby sucking and stimulating mom's milk supply effectively?  Is she
actually experiencing let down?
Are there loooong "drinking a milkshake thru a straw" sucks? or primarily
just fast suck-suck-suck-suck?

As far as calories go, finishing the first breast first is the way to go as
the hind milk is going to have a higher creamatocrit (read "higher calorie
content") but of note - mother nature won't let mom make "diet" milk for
baby, but she does leave it up to baby to get that milk out. That's where
I'd start looking for clues.

Hope this is helpful.
Gail-
Gail Hertz MD  pediatric resident, author of  little green breastfeeding
book - disclaimer: owner of pocket publications