-- baby is 3 weeks old, and is still 11 ounces below  birth weight.
Between weeks 2 & 3, gained 1.5 ounces.

Jan, my experience with situations like this is "if it doesn't make sense -
then it DOESN'T MAKE SENSE" it good you trust your instincts...
A few times I've been "caught" by making assumptions I shouldn't have.
Some things to consider:
Has baby always been feeding this well? Did something recently happen to
improve the baby's ability to bf well?
Did something just happen that would have increased moms milk supply?
[stopping a med or herbal preparation?]
If these are the scenario - then the weight will correct itself in a few
days --- when is baby to be weghed again?

> Mom is bf at least 9, sometimes 10 times in 24 hours.
You know mom - this you believe...

 Diapers are SOAKED;
cloth or disposable?

> usually 2 good sized stools a day with some smears in between.  Stools
yellow,
> seedy....
just 2 poops?  Was there ever more than that per day?

> Weight showed 3.7 ounces taken at that feed (which was approximately 2 --
> maybe 2.5 hours since the last feed.)  Adequate intake at a feed for a 3
week
> old infant.  Assuming average intake of maybe 3 ounces/feed x 9 feeds/day
= 27
> ounces -- certainly adequate for growth.
If all feed are this good....
Did you see her in AM or mid day or later?

If I had 6 other children, I'd be hard pressed to have time to sit, rest
and make milk, nevermind breastfeed!

You said in another post baby looked healthy.
Also ped had just seen baby 2 hrs before.

Possibilities :
1 Hx of not enough milk - resolving - will fix itself

2 milk that is going in not being processed/absorbed  - problem will
continue
??? does poop smell funny/ bad/ strong??? (malabsorption)  Cystic Fibrosis,
Schwachman-Diamond, pancreatic insufficiency, misc metabolic problem (is
the baby developing normally otherwise - recognizing mom, etc?)

3. Increased metabolic demand - baby needs more cals due to secondary
problem ie. cardiac defect, (does baby sweat when he eats?)   infection
also uses more calories,  metabolic defect in energy processing -
mitochondrial disorder   these will not go away by themselves either.


Actually  saw a case that sounds very similar to this - very good mom -bf
her 3 other kids - very reliable but had no help at all not even from dad.
When we actually counted she was only feeding about 5 times a day. She was
doing her best.

Gail
Gail Hertz, MD, IBCLC
Pediatric Resident
author of the little green breastfeeding book - disclaimer: owner of Pocket
Publications










>
> So, what's the problem?  Obviously something else is going on here -- and
it
> isn't a mechanical problem, or a milk supply problem.  (We are working on
> increasing caloric intake by making sure baby is extracting every LAST
drop
> (almost) from breast 1 before going to breast 2 -- and maybe even bf x 2
on
> one side before going to side two.
>
> So, on the face of it, the weight tells me she is getting adequate volume
(at
> least at this feeding).  It doesn't tell me why the baby isn't gaining
weight.
>
> Yes, mom is reliable, so if she tells me that she is bf 9-10 x/24 hours,
I
> believe her.  (We've worked together before on 3 or 4 of her other
babes).
>
> thoughts?
>
> Jan Barger
>