I would interview her about her feeding schedule. I was working with a mother who had the same issue with her first baby. No weight gain, low quality milk, etc. She discontinued breastfeeding early with no lactation support. I met her after she had her second baby-- no breastfeeding was initiated and baby was failure to thrive. Doctor sent her to me for help with bottle feeding and concern about posterior tongue tie because she was taking so long to eat.  After much discussion it turns out baby is sleeping 10 hours at night and mom is unwilling to wake her for night time feeds. Her expectation is that her baby should sleep through the night. Baby was getting half the calories she needed by bottle. I asked our dietitian to help with finding her a higher calorie formula. She was adamant that it was not worth interrupting their sleep to give a bottle. I felt pretty helpless in that situation because I didn't feel there was an oral restriction or any other issue with baby-- her calories were restricted because of a harmful cultural narrative that you do no need to parent your baby at night. 

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