I would welcome your thoughts on a situation I was helping a mother with
today.  The baby is five months old and is fairly small, but healthy.  The
mother began offering solids early (four months) and feeds solids once per
day.  At the last visit to the pediatrician the doctor expressed concern
about the baby's weight gain.  The mother began nursing more frequently -
every hour and a half (the baby was previously going longer than two hours).
 After several days the mother was wondering if the increased nursing was
making a difference, so she waited for a full eight hours (!) between
nursings and did not notice any engorgement.  She has been under stress
because of studying and reported that the baby has seemed less interested in
nursing over the last few weeks.  The baby has a pacifier, but the mother
says that he plays with it with his tongue rather than sucking on it.  She
does not often feel a strong letdown.  I suggested that she listen for the
baby's swallowing pattern, as this will give her a clearer idea of milk
transference than the amount of time she spends nursing.  I also wondered if
the baby might be experiencing discomfort because of teething.  (He has been
drooling profusely for the past month, but no teeth have erupted.)  I would
hope that eliminating the pacifier and solid foods would increase the milk
intake.  Does anyone have any ideas?

Thank you.

Lesley Robinson, IBCLC, LLL Leader
Corning, NY