Jude, I agree, these discussions are stimulating. I work alone as the
hospital's "Lactation Specialist" so really benefit from the sharing of
ideas that goes on here. Guess I misunderstood the original posting on this
(and it's long gone now),but I thought this was regarding a baby that was
nursing fine, had an elevated bili, and just wasn't back to birth weight by
day 5. I too  see most of our babies back at birth weight by the 1 week
check. But I think the 2 week guideline is still a good one. Sometimes we
can put too much emphasis on weight gain, implicating there is something
wrong with the mother's milk or her ability to nourish her infant. Then
formula is brought into the picture, further diminishing the mother's self
esteem, and they are at much risk of tossing the whole breastfeeding
relationship aside. Certainly a baby at risk needs to be monitored closely;
the mother needs support, guidance, and information so that the baby's
nutritional needs are being met. But I think it is important to do this
without undermining the mother's self confidence.
 Your comment about the larger birth weight babies taking longer to regain
their birth weight is also interesting, I've seen that occur and heard it
from other LCs. Also recall hearing that much of the initial weight loss is
a normal occurance as a result of fluid loss from baby's tissues, after
soaking in amniotic fluid for 40 weeks. Any thoughts on this? Mary

Mary A. Banaszewski, RN, Lactation Specialist