Katherine in Atlanta posts about a case in which the fully breastfed baby of a mother who has undergone reduction mammoplasty, after an an initial somewhat prolonged drop in weight, began gaining well at just over two weeks of age and has continued to gain normally thereafter. The baby, according to the pediatrician, 'looks great, is healthy, happy, sleeping well and is appropriately alert' but this same pediatrician fears that the mother is sacrificing the baby's health 'on the altar of breastfeeding'. Say what?! What would it take to convince the doctor that the baby is thriving? (And last time I visited my local house of breastfeeding worship, infant sacrifice was definitely *not* part of the liturgy. What faith does the doctor think the parents adhere to, anyway?) Of course I guess the concern is understandable, since slimness is a major public health menace in the world today. (!!) My short answer is that I agree with you, Katherine. The problem has been solved and everyone can stop worrying about the establishment of breastfeeding in this case, and look forward. Regarding the events of the first two weeks, it sounds as if the baby was carefully followed and was not in danger at any time. There is very little solid evidence to inform practice regarding atypical weight losses in the first two weeks of life, which is surprising considering how much practice is engaged in during this period. I think with a shudder of all the uninformed measures I know of during the first two weeks which definitely jeopardize child health and long-term breastfeeding, particularly supplementing without a clear plan or goal beyond making the numbers in the display window on the scale change quickly. Whenever I see a baby who is nearly ten percent below birthweight at a week, I want to know why. In this case I would have chalked it up to the delay in the big surge in milk supply which IME is common in women who have known physical factors affecting breast function. I would have wanted to see the baby to satisfy myself that the baby looked good - bright eyes, happy to feed, peeing a lot if not pooping copiously yet, and that the parents truly fed the baby at every sign of hunger. It sounds as if this was done, and it sounds as if the parents are realistic, and not trying to implement three-hourly feeds lasting fifteen minutes each, or not feed the baby all night, or some other ridiculous wrench people sometimes throw into the machinery. And when the baby started gaining like gangbusters after two weeks, I would have rejoiced with the parents, congratulated them on a job well done, and QUIT WORRYING. The doctor can measure the baby's length too. Usually when weight gain in a thriving child slows down, it's because the child is growing in length that week instead. Cheers Rachel Myr *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome