Just wanted to share a postive day in the life of a Ped/LC. I've been working with a challenging/rewarding BF couple. T.J.'s birthweight was 6#12oz. He was seen at 2 weeks of age by another ped with a 1# weight loss, down to 5#12oz. Fortunately, I saw the babe 6 days later for a lactation consultation. Mom is a primip, very dedicated to BF but with a somewhat overbearing,"did not BF is this worth the trouble", mother. Lots of personal stress on top of some latch problems and a fussy baby. We had a positive session and I asked to see the babe back in 3-5 days. At this time his weight was 6#3oz. Unfortunately, they never came back in until now at 2 months of age. His weight was 6#13oz - only 1oz over birthweight!!!! The history was that the babe was always hungry, seemed eager to BF, would only suck about 5-10 minutes and then fall asleep. He had 6-7 wet diapers/day but only one small stool/day. I observed a nice latch and a mom with a good milk supply. She was also intermittently pumping 2-3oz at a time. The pediatrician side of me is looking at a FTT and I'm worried about all the metabolic or other potentially serious medical diagnoses. But besides being thin, this kid was vigorous with a strong suck and good tone. No murmur, no enlarged liver, nothing that grabbed me as really "abnormal." I resisted the urge to hospitalize (which I really caught some flack for) and did outpatient screening labs. Somehow I felt that this babe was taking "everything off the top" and never getting down to the denser, rich hindmilk. I was pretty worried, as was the family. The labs were all normal, no evidence of acidosis or dehydration. I trusted my instincts decided to give him a week on a new feeding schedule. I had mom keep him on the first breast as long as she could then switch if he was still interested. She started more freq. pumping and offering the hind milk after BF with a NUK nipple/bottle. Grandma thought I was nuts for not just putting him on ABM, but I felt the mom really wanted this to work (and so did I!). He came in today and weighed 8#7oz!! A gain of 1#10oz in ONE WEEK. I've never seen this before. We were all near tears of joy. He looks great! My other uplifting experience of the day is a mom who had breast reduction surgery 8 years ago and now is producing LOTS of milk. She had the "below the breast and up and around the areola"incision. She was told by her OB to just forget about BF (how terribly supportive) but I gave her the OK to go ahead and "secretly" pump. The baby is now 4 days old, she actually felt some engorgement and he is going right for the breast and wants nothing to do with the ABM. What a bright kid! Days like today make it all worthwhile............ Karen J. Stepan, DO, IBCLC [log in to unmask]