I have been a member of Lacnet for a couple of months and I enjoy reading all that you have to say.  I have received alot of valuable information.
We have a puzzling situation that I hope someone can help shed some insight for us.
We have a mom who has a one month old.  This is her 3rd breast baby.  She BF #1 for 3+ years (one year she tandum nursed).  #2 weaned himself one week before #3 was born.  #3 has been a challenge for all of us!!!  I first met this mom through the LLL meeting held in our office.  She dropped in to the office because baby was not gaining.  9 lbs 1 oz at birth.  At 5 days she was 8 lbs even. She had just left dr. office and he was not concerned about the weight but he did do a bili as baby was jaundice.  We weighed/fed and reweighed on our M****a scales.  Baby took .3 oz in 30 minute feed.  Mom did not want to use a nipple but was willing to use an eye dropper or a soft cup.  2.5 hours later she called back to the office and baby would not take anything not even suck on finger, she had even tried a bottle.  We encouraged mom to take baby to dr. to been seen.  Well, bili was 24 and baby landed in the hospital under the lights.  Once bili was down and baby was more alert she began to nurse some better but not great.  Mom was concerned that baby was getting nipple confused in hospital.  Baby did finally get back to breast but after d/c bili went back up to 17 and she was on home therapy.  Weight is still not good.  Mom has been pumping and milk supply is good.  Baby has good latch on and appears to be nursing well but she only takes in about 1 ounce. This is after 45 minutes of feeding. Goes to breast easily and is not nipple confused.  Mom pumps out 3 more and baby will take it from a bottle without trouble.  Even though this mom had alot of BF experience, her confidence is low.  Weight in office on Friday at one month was 8 lbs 8 oz.  She is still 8 oz below birth weight.  Baby constantly acts hungry unless she gets the bottle.  Hard palet looks low but soft palet bubbles.  Could this cause the inefficient milk transfer?  We appreaciate all suggestions.

Thanks for taking time to read this long senario.

Debra Knight, R.N., ICCE