I would observe at least 2 feedings - and one with hand expression (or breast massage) during the feeding - this baby may not be good at milk transfer, and mom's milk supply is being compromised as now it depends on how well the breast is drained - this could lead to a slow but steady downhill turn, with no really noticeable symptoms - saw a serious issue of a 3 month old with only 8 ounce over birth-weight and a mom denying any problems!  (On the other hand, having a grandson in the 3 - 4th percentile for 3 years, IF you see everything is fine - I would have some weight checks every 2  weeks for a while to make sure no serious issues have cropped up...).

A mom that I saw at a support group had a THRIVING 2 1/2 month old - AND reporting carpal tunnel pain and exhaustion.  When baby was a few days old, she was not doing well, was "early mature or late premature" and was helped with a wonderful home visiting nurse and WIC staff to increase milk production by breastfeeding, pumping and hand expression, followed by bottle feeding if needed - except she was never told to STOP doing those things - now she is SOOOO tired of "breastfeeding/pumping/hand expression/bottle feeding."  AAARRGGGHH!

We need to make sure moms hear/know when their interventions can STOP!

Jeanette Panchula, BA-SW, RN, PHN, IBCLC
California, USA

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