I see this sometimes - and yes the Pedi's get all up in arms. What I usually 
see is a fussy, unsatisfied baby, who has lots of urine out but poor weight 
gain. I feel is related to alot of foremilk, not enough cream. To get a 
more "rapid" weight gain,( to keep the Pedi from RX formula) & If mom has an 
abundant milk supply, I will have her express 1/2 oz - 1 oz. foremilk, then put 
the baby to the "primed" breast and nurse using Breast Compression to 
improve milk transfer and milk fat %. This usually works really well, the slight 
overproduction balances out as the baby takes more volume, and mom stops 
the foremilk release when back to birth weight and the Pedi is more reassured. 

Paula Hiett RNC, IBCLC 
Longview, Texas

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