I weight the baby's condition more than the weight gain.  If the baby is
weak and low energy, he or she is not going to be able to feed well.
These are the babies I supplement, right away.  Babies who are gaining
slowly, but still seem energetic, I will try to improve breastfeeding
efficiency and follow them closely for a few days to see if their intake
increases before making a decision.
I usually go for 2oz daily per 1oz weekly weight gain deficit.  For
example, if baby gained 3 oz last week, but needs to gain 5, we would
give 4 oz per day, preferably breast milk expressed after nursing.
I use 2 to 2.5 oz of milk/formula per pound of body weight to determine
milk needs, the lower range for human milk as it is efficiently
utilized, the higher range for abm.
And if baby has lost a lot (I have worked with infants that lost 20% of
birth weight), we feed as much as mom can possibly get into the baby.
--
Catherine Watson Genna, IBCLC  New York City  mailto:[log in to unmask]

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