Of course milk insufficiency really does exist.  However, the most
common reason for a baby not gaining well is that he is not getting the
milk that is available.  Of course, once the baby has been nursing
poorly for days or weeks, the milk supply often decreases secondarily.
We all know mothers such as the one I saw yesterday with her second
baby.  I saw her with her first baby.  The usual poor start.  The early
introduction of supplements.  Sore nipples.  Never developed a good milk
supply, always needed supplements.  Weaned rather early.

Yesterday, there she was with her 3 week old, and an *oversupply* of
milk.  Baby gained tons since birth.  Drinks beautifully.  I think she
came for reassurance.  I'm glad she learned something since the first
baby because frankly, the staff in the hospital where she delivered
both, haven't, but she was able to fight them off.

You could start every baby this mother had poorly, and she could be
considered a "poor producer".

Jack Newman, MD, FRCPC