I've appreciated all the comments about initial weight loss, and consideration of "normal."

I count diapers, adding wet and soiled, and matching those against ounces lost.  I've noticed that, in general, babies who have 2-3 times the number of diapers as ounces lost are feeding well, whereas babies who have just about the same number of diapers as ounces lost, are having some kind of feeding issue.

I appreciate the value of assessment.  Using weight loss as the single marker to justify supplementation is too narrow a vision.  I try to ask the nurses to use a range of indicators; muscle tone, skin tone, skin color, alertness, general behavior, signs of calming at breast.  

Again, I feel that if I could document number of times (or amount of time) baby is separated from mother, I could show a relationship between separation and feeding problems.  Just wondering how to go about it.

Jeanne Mitchell RN IBCLC
Austin, TX

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