Janna
First, let me say, that I have come to believe that 37 wks is not full-term!
Most of these babies do not breastfeed "robustly". Babies under 6.5 to 7
pounds are needing close followup, IMHO, especially if also born early or
under adverse conditions.

I am just calculating in my head, that a 5 lb baby needs *about* 12.5 oz per
24 hrs which is a little over 1 oz every 2 hrs or 1.5 oz every 3 hrs. It
sounds like this baby never got even an oz per feeding and I wonder how
often he feeds.

So, in general, I think the care plan for this mother needs to just go to
the 3 basic *rules* of 1. feed the baby generously by alternate route, 2.
protect the milk supply with super duper pump and regular pumping, 3.
finally get the two of them bf happily together.  It sounds like the baby
did the best in the 24 hrs with generous syringe supplementation. Probably
need to go back to supplementing the bf quite a bit. I find when the baby
gets to around 7 pounds, they do much better.

Now another issue of the loud noises, gulping noises with very little milk
transfer, you may have to look at other oral issues (maybe a small cleft?),
breathing and/or swallowing issues.  Also it does not sound like the mother
ever has had a "milk surge" or engorgement phase, so that needs to be looked
into as well.

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

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