Hi Gloria--

Did you say that the baby was:

"6 lbs 14 oz at birth, 6 lbs 9 0z at discharge and 7 lbs 8 oz at two weeks.
mom is concerned about milk production"

I do not see a problem here...the baby lost less than 10% of its body weight
by discharge and had not only regained birth weight, but was 10 ounces above
it at the two week point. I do not know why the mom is even supplementing.
Perhaps the baby is constipated due to the formula??? But not likely!! Am I
missing something?? I reread the post and do not see signs of a problem here.

Supply problems can always occur, especially with a mom who does not
understand how milk-making actually works. Giving any supplement without
pumping fools the body into thinking it is making enough for the baby--the
body/breast has no way of knowing that the baby is being fed extra from
another source unless it is "told" (by pumping to replace the supplement). I
am trying on a daily basis to get the nurses where I work to understand this
simple process.

Prolactin (the milk-making hormone)comes from the anterior pituitary while
oxytocin (the milk-ejecting hormone) comes from the hypothalamus and is
stored in the posterior pituitary. It is conceivable that  if she had the
posterior pituitary removed, the oxytocin could be delivered directly into
the bloodstream as needed from the hypothalamus. If the mom was missing the
anterior pituitary, she would also have problems with LH and FSH (the
reproductive hormones). Low thyroid can also contribute to milk problems, so
both of these conditions bear watching.

With good weight, and good wets, you have to actually look at the baby to see
if there are other problems. It sounds like a normal 3 week old, nursing
every 2 hours, with lots of non-nutritive suckling, and wanting to "recreate
the womb" situation by being held closely.

Maybe this mom needs an explanation as to life according to the baby's point
of view. It had been continuously "rocked, held and drip-fed 24/7 for 9
months" (as I explain it to my moms)....now we expect it to go a long time
between feeds and be able to be left alone????
Good luck.

Kathy Rubin in NJ
IBCLC, RN, BC (Maternal/Infant), APN, C (Family Nurse Practitioner)
PhD student hopng to study lactation issues someday

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