Heather, You are right that the baby doesn't necessarily need so much milk the first few days. Remember, this is not an exact science and follow-up is very important. However, I have seen too many underfed babies and part of that is because the parents are not offering adequate quantities to the baby or offering enough feeding opportunities to get in enough calories. Often the parents just don't know what to give. Also I want to make the point again, that these calculations are for babies *not feeding effectively* at breast. In other words, the situation is not a normal one. I watch the weight loss prior to discharge, and I find jaundice goes hand in hand with this. Almost every baby with a larger weight loss is not feeding well, or not feeding often, or the mom seems to have scant colostrum, and baby is becoming visibly jaundiced. If we send the parents home and say just keep working with the baby then the baby may present at the end of a week in severe trouble and so may the mom (engorgement/low supply). I usually give the caveat that in the first 48 hrs the baby may take a bit less but generally by day 3, I expect the baby to be taking the larger amounts. Often the baby begins to feed effectively by day 2 or 3 and no supps are needed. (EBM always your first choice, of course). Here's an example: Baby is 7 pounds. I calculate he needs 2.5 oz x 7 = 17.5 oz per 24 hrs (approximately). If he's only taking in 1 oz every 3 hrs, he is getting 8 oz in a 24 hr day, which is going to get him into trouble very quickly if he persists with this amount. It would help if he took 1 oz every 2 hrs, but that would only give him 12 oz in the 24 hr day, which still would not give him enough for growth. Some parents even give 1 oz or less every 4 or 5 hr; they just do not know baby needs more. If the baby truly cannot or will not take in the necessary amounts by about day 3, then this needs to be evaluated further with the physician. And f/u is so important. Hope this helps to clarify how I manage these babies. Thanks. Laurie Wheeler, IBCLC, MN, RN New Orleans Louisiana, s.e. USA *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html