Riva Weissfish asks for input on this case: a 2 1/2 week old first baby whose tongue-tie was dealt with at 9 days, at which time mother also started taking domperidone and 'increased pumping'.  Baby is feeding frequently, seems satisfied and alert and settles to sleep after feeds.  Baby is also getting fed the milk mother has expressed, plus some formula, for a total of 120 ml of supplemental feeds daily, divided into two portions, and is gaining 150 g per week.

Riva's question is how to proceed when the baby now has not stooled for 36 hours - should the mother supplement more? Should they try pre- and post-feed weighing?  How long can they observe the baby and wait for it to stool? 

My questions:  How frequent is 'frequent nursing'?  If supplements weren't an issue, I would wonder if this baby was experiencing a growth spurt and is simply using everything he/she? is taking in.  If the baby is feeding well, wouldn't more frequent nursing result in more fuel (and perhaps some 'leftovers') and also eliminate the need for supplements?  The mom is able to express milk after the baby seems done, so putting the baby back to the breast should provide more milk, no?

I don't have enough personal experience with formula to know how it could impact this, but have read that iron-fortified formula can cause constipation - could that be the case here?    

Ingrid
LLLL, IBCLC
British Columbia
Canada

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