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Expert Q&A

	By Ann Calandro BSN, RNC, IBCLC Lactation Consultant

My baby boy is now 11 days old. He was weighed today at the physician's office, and he hasn't gained any weight. He weighs exactly 6 pounds, 8 ounces, the same as he did when we left the hospital and at 4 days of age. My physician is having me supplement formula every other feeding and pumping to be sure he is capable of gaining weight. I am doing as instructed, but am heartbroken at the same time. I really don't want to have to switch to bottle-feeding. I think I have enough milk. I leak profusely and often have to express some before my son latches on because it chokes him otherwise. Any suggestions or help would be greatly appreciated."

I think your best bet would be to see a lactation consultant. Over the Internet it is hard to know why your baby's weight remained the same for a week. Is your baby having at least six wet diapers and three yellow bowel movements each 24 hours? When he latches on, do you hear swallowing, and does your breast soften with each feeding? Does your baby nurse eight to 14 times a day? Has he been jaundiced? If he has been jaundiced, that may have caused him to be sleepy and not eat often enough. If your baby looks a little yellow, it is time to feed more often, even though babies who are jaundiced would sometimes rather sleep.

The problem could be the latching on. Is your baby latching deeply to your breast with his chin tucked deeply into your breast and his mouth wide open? Does breastfeeding hurt? (It shouldn't!) Are you pumping as well as nursing to keep your milk supply up? Have you tried pumping a little to soften your breast before feeding so that your baby can latch more deeply?

Ask your physician if you can stop the formula for 24 hours and work on only breastfeeding very frequently and return the next day for a follow-up weight check. See if you can get in to visit a lactation consultant who can observe your baby nurse, do a before and after nursing weight check and offer some suggestions on how to stop the formula and get the baby totally back on the breast.

Since formula digests slowly, babies tend to eat less often and less vigorously when they go to the breast if they are receiving both types of feedings. It is not too late to seek help and turn things around. Waiting much longer may cause your supply to be severely depleted.

I wish you and your little one well.
Ann Calandro, RNC, IBCLC"

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