Since he's losing weight, that would be a clear reason for the 
increasing lethargy. I think 20 mins of ineffective bf on each side is 
too hard on his reserves, and he's unlikely to get sufficient milk by ff 
once he's so tired. Since he can latch and does attempt to suck, try 
using a syringe and tube at breast, and have mom bolus him from the 
syringe with every suck. Make sure she knows to give him a 2-5 second 
respiratory pause every 10-20 sucks until he's strong enough to take 
them on his own. This will make feeding much more efficient, giving mom 
time to express milk to use in the syringe.

If getting more milk into him (horses) doesn't result in growth and 
greater alertness, then exploring the zebras (medication effects) would 
be warranted. I suspect they are a small piece of the picture, but the 
largest part may be that he's just not feeding effectively.

Catherine Watson Genna BS, IBCLC  NYC  cwgenna.com

On 5/24/2013 2:17 PM, Michelle Scott wrote:
> Has anyone seen this?  A vag deliv, 7 # plus baby, did some 'posturing' per
> nursing shortly after birth.  Since birth he has been hard to keep awake
> during feeds.  Gained a little after mom's milk came in, then some loss at
> next wt ck, continued loss of only 1/2 oz in 5 more days.  We are having
> mom supplement with SNS on finger, after she has nursed for 20/side.  She
> now knows what a suck/swallow looks like and has to constantly nudge him to
> keep him awake.  Sometimes in the middle of a feed (5 min in) he is relaxed
> looking like he is full--arms out, hands open.  But he has not been nursing
> vigorously, and if taken away from the breast and changed, he may wake up,
> or he may continue to sleep.
> Mom is on Wellbutrin, and Cymbalta, and has been thru the pregnancy.  Work
> ups for cardiac/respiratory, infection, all come back negative.
>    I thought of taking him off brmilk, having her pump to preserve supply,
> to see if her milk is causing the lethargy, but if it is the drugs, I worry
> that he may have withdrawal symptoms.
> Any suggestions?
>

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