This kind of test weighing is not accurate as was done in the pedi 
office. I would hope that when you did an LC consult, you did test 
weights yourself on a good or appropriate scale. That is what needs to 
be done instead of guessing and messing around. If baby has an oral 
motor issue, it is often going to look like excellent sucking, and you 
even hear smacking and swallowing, but the intake is poor for all the 
effort.

My other idea is perhaps baby is not eating often enough. If baby truly 
took in 2 ounces at the breast, a baby this size needs to be eating 12 
or 13 times in 24 hours. Two ounces times 8 feedings is only 16 ounces 
which would make him lose weight. I find that SNSs don't work with oral 
motor issues very well, as baby is just not able to suckle well.

I have worked with many babies who can only removed something low, like 
maybe 1.5 ounces before their mouths quit working right. I know this 
from doing multiple test weights on a scale accurate to 2 grams that 
weighs down to 3 ml. These babies do not gain weight properly.

I am sorry if I sound rude about the scale but  so many of these Lactnet 
posts have everyone guessing and coming up with odd theories when really 
the first issue needs to be assessment of how much baby is removing at 
the breast. (And please.... let's not get into that inane argument about 
how using scales is inaccurate.)

If baby takes in a good amount with you but then is not gaining weight, 
have mom do several test weights over a day. I have worked with too many 
oral motor problems where baby looks good at the breast, but removes a 
low quantity of milk for the effort exerted and at some point, usually 
after 10-20 minutes of sucking starts to remove NO milk with what looks 
and sounds like perfect sucking.

Kathy Eng, BSW, IBCLC

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