I recently worked with three mothers, all from the same pediatrician (not
a surprise to me, unfortunately) who had not regained birth weight by 10
days.  They were close, but not quite there (2-3 oz).  The pediatrician
gave them my phone number to rent a pump (the saving grace).  They were
told to pump to increase milk supply.  If they didn't get 3 oz of pumped
milk they were to add formula to the EBM and give that to the baby after
10 minutes of breastfeeding on each side.  Talk about a difficult
position.
I will make this short.  I saw them all within one week.  I educated each
mother about Supply & Demand asked them if they would agree to follow a
plan of breastfeeding the infant as long as the infant wanted to feed.
Using switch feeding (switching sides as soon as they stopped hearing the
infant swallow).  Made sure all of the infants were latching on
correctly.  All of them were not (of course-so not really breastfeeding)
and also educated them on how to use breast compression (thank you Dr.
Jack).  I then asked Mom to count diapers and come back in two days for
another wt check.  The physician had them coming back in three days.  So
I was a day ahead of that visit.  Also recommended that they spend those
two days having a breastfeeding marathon.  Feed every 2 hours during the
day.  All three mothers agreed that the plan made sense to them and they
would try it.  I must have been more convincing than than usual.  Two
days is a reasonable time, I figure and it usually works!!.  Well of
course all babies gained wt.  All were above birth wt. when they came
back for wt check.bb One gained 6 oz, one 8 oz and one a whopping 10 oz.
Small study, but good results.  If only I could convince all mothers and
pediatricians that this plan would work or at least try this plan first.
Just had a lucky week.  I haven't heard a word from the pedi, but she
gets a copy of my consult.  May never hear from her, but accomplished my
job.  Had happy moms and babies.
Thank you,
Darlene Breed, BSN, RN, IBCLC
Coordinator, Milk Bank & Breastfeeding Center, Worcester, MA (USA)
Treasurer, Human Milk Bank Association of North America (HMBANA)

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