Unfortunately, many moms (at least around here) are sent home with NICU "graduates" and orders to supplement with a specific number of ounces of milk (too often formula, but sometimes EBM) after each feeding, regardless of how baby has nursed.  When baby is satisfied with breast alone, many of these moms feel guitly not being able to get the "required" number of ounces into the baby afterwards will often give the supplement first just to be sure baby gets it.  This is, of course, a recipie for breastfeeding cessation.  Yes, we need to educate the docs who give these blanket orders.  Yes, we need to take into account the fact that babies' appetites will vary feeding to feeding.  Yes, there are a number of things wrong with this scenario and we do need to work on getting it changed.  However, in the meantime, until change can happen, moms have these orders and too few have the confidence to do anything counter to those orders.  
Given this scenario, I would prefer to see the moms "test weigh" and give any supplement based on what the baby took at breast giving only the amount of supplement needed to meet the "ordered" total for the feeding than to always feel she has to give the same amount after a nursing.  Yes, there are many things wrong with this scenario, but not as much wrong as it is when moms are told to always try to give the same amount of supplement regardless of how the nursing went.
If only is was a simple matter of getting everything to change for the better with a simple snap of our fingers (figuratively speaking), but we have to deal with the reality that exists at the moment while trying to change for the better in the long run.  The research I would like to see is how many mothers continue to nurse and how long if they can at least base supplement on what the baby is getting at breast as opposed to  those who are told to always give the same amount regardless of whether baby guzzzled for half an hour and has milk running out its ears or barely gave the breast a "lick and a promise".

Winnie

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