This case illustrates the dilemma when low intake FOR WHATEVER REASON has
gone unrecognized or un-dealt with for too long.  The baby's ideal growth
trajectory gets farther and farther from the actual growth trajectory with
each passing day.  By the time you start fixing things, there may be a large
gap between the baby's current weight and the weight the baby's body is
programmed to be.  In the case discussed here just now, the mother was
fortunate to have her own expressed milk available to use as a supplement.
Once baby is back on track, odds are it will be feeding more effectively,
not to mention more happily, and may well be able to meet all needs at the
breast.  But until the gap is closing, in my experience there will likely be
a need for extra food for a time.  How long depends entirely on how good
mother's supply is, how easy it is to increase it, and of course how far
behind expected gain the baby is when you start.

I note with some curiosity that this mother had a supply of expressed milk
socked away in the freezer.  Ellen, do you know why that milk didn't go into
the baby when it was produced?  I ask because I have heard that in at least
one book on the market that advocates strictly scheduled feeds from day one
(The Contented Little Baby Book), mothers are instructed to pump both
breasts after three of the scheduled feeds every day.  The rationale for
this, according to the book, is that when baby hits a growth spurt, the
mother can simply breastfeed and not pump for the days while baby is
requesting more milk, since she always has more than the baby needs
otherwise.  This is meant as advice to save the mother work, if you can
believe it.  As though pumping three times a day in addition to being full
time with your baby, instead of just feeding when baby is hungry right
along, is less trouble.  I was told this by someone who uses the book.
There did not seem to be any suggestion about what to do with all the milk
you express for those periods when baby doesn't need it.

I am much too lazy to follow such a program myself.
Rachel Myr
Kristiansand, Norway

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