Sounds like both of your cases are related to faltering milk supply. Pacifier use may be the culprit and in my opinion should be discontinued with any baby with weight problems. Have you inquired about meds especially decongestants (Claritin D for example) and contraception? Any chance of pregnancy (unlikely)?

Re Baby A (chubby, eczema, transferred 80 mls in 10 min) - sounds like baby was coasting on mom's initial good supply and now supply is faltering. Baby needs to be taught how to latch effectively and mom should discontinue pacifier and feed very very often with breast compressions. Do a weight check every couple days and if not gaining, then may need to express extra times to increase supply or possibly take galactagogue. If supplementation is required by alternate method, there are several tube devices, eye droppers, periodontal syringe at breast. Bottles can be given by another person, find one similar to pacifier, if needed. Remember the cornerstone of increasing supply is frequent effective milk removal. Possible food sensitivity is also in play due to the eczema, so that requires some detective work. I usually look at the most common allergens and ask mom if there is a food group that she eats alot of (e.g. peanut butter or dairy).

Baby B (long lean starving look) sounds more concerning. A 40 ml transfer (although it's just a snapshot) is very low for an 8 wk old. Some moms with many older children have trouble feeding responsively (this has been discussed on lactnet before - check archives) and the baby misses some feeds. It seems this baby is willing to take additional milk with the tube, so should be generously supplemented. Mom can attempt to increase supply with expressing if she can. The baby may have reflux so that should be investigated. Look carefully for s/s thrush in baby's mouth, but that may not be the issue.

Hope some of this is helpful.

Laurie Wheeler RN MN IBCLC
BMH-UC Breastfeeding Resource Center
 "Opinions expressed above are not necessarily those of BMH-Union County or Baptist Memorial Healthcare Corporation."


Baptist 100. Well beyond a century.

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