Deborah,
Welcome to our wonderful forum and I bet you passed the exam!

You said "I guess I'm just really confused as to why supplementation was
recommended instead of close observation and follow up with not even a 10%
weight loss in a full term infant. And if supplementation was deemed
medically necessary, why this mom was told that a supplementation system at
breast would have been "too much hassle" for her..."

Deborah, you're not confused, but some others in the healthcare team sound
like they are. Several points I will make. 1. The baby may or may not have
needed to be supplemented, not necessarily due to the wt loss, but whether
the mom had her own milk to provide or not. 2. Supplementing at the breast,
if possible, is usually best for the baby to learn bf, however discuss the
options with mom (benefits and risks of each method, or adv. and disadv.)
and she decides in consultation with you. 3. Lots of discussion among
lactation people and in our archives re wt loss, looking only at the
numbers, what these numbers mean etc. My understanding is some schools of
thought recommend intervening (whatever that may be) at a 7% wt loss. Most
babies that are in fact doing very well with bf and kept close to mom at all
times, and with a mom with normal bf progression, IMO, drop wt only slightly
and are gaining by 4th or 5th day, and by 2 wks are generally well over
birhtweight. If you've been lurking long you probably have read very
thoughtful comments by Dr. Jack, Barbara Wilson-Clay and others on this. 4.
In my experience, many times healhtcare workers recommend formula
supplements when in fact the mother has the milk to give even if the baby
cannot effectively get it out of her w/o help, and these same hcps forget to
work on mom's supply if in fact formula is (temporarily) needed. I could go
on, but you get the point. BTW, you are going to be asking yourself these
same questions that you asked above, and more, for a long time to come
unfortunately, if you stay in the business of bf. Keep the faith.

Laurie Wheeler, RN, MN, IBCLC
Violet Louisiana, s.e. USA

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