I would want real test weights with a good scale, like a Medela BW or 
Tanita BLB12 and see if this is a normal intake amount. Baby might need 
24 hour test weights at every feeding just to see what is going on. I 
suspect baby is not removing milk this well. If baby was weighed on a 
regular pedi office scale, it may only be 1 ounce gain. I would do a 
history of how often, how long she is nursing, diaper counts, 
engorgement or breast fullness, and I would ask mom to keep a written 
record because sometimes her recollection is different than reality. I 
would want to know every nursing session start time, every bowel 
movement change in diapers. Watching the baby nurse is not accurate. I 
have seen babies look really good, chomping away, loud gulping sounds 
and 3 ml intake. I would expect this baby to be weak and needing 
supplementation. I would probably supplement 1 ounce per nursing session 
to get the weight up. I might have mom use a supplement at breast and or 
pump with a rental pump after most nursings to see if she can increase 
her supply. I would have her nurse on each side about 10 minutes so that 
each breast is nursed twice, right 10 minutes, left 10 minutes, right 
5-10 minutes again, left 5-10 minutes again. I would prefer supplement 
at the breast with a SNS type thing or periodontal syringe. If mom 
prefers bottle, I would have her start with bottle after nursing but 
once baby perks up, try the bottle first.
Good luck, I think the pedi is grasping at straws in recommending 
another LC or should be terribly concerned about this drop in weight and 
how the baby has not regained birth weight by 10-14 days. If the mom 
told them that you, her LC said this was fine, the doctor would 
naturally think you are lax. Not saying you are, but sometimes the story 
gets told differently than it really happened.

Good luck, Kathy Eng, BSW, IBCLC
PS: This is why HCP reports are vitally important. When we send a HCP 
report expressing our concerns on the initial consult we did, the doctor 
would know our side of the story.

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