Mommy in the middle

The lactation consultant is ALWAYS going to choose no supplementation, even with expressed breast milk. Some gobbledygook about nipple confusion. "Breast is best" doesn't exactly mean "breast is only" though. Infant formulae (artificial baby milk, as the nipple nazis call it as a scare tactic) have been refined and refined over the last decade to provide as complete nutrition as possible. Whatever is the woman to do who has had a double mastectomy, or is on immunosuppressants for an organ transplant, or has no use of her arms from a spinal cord injury? I don't know about anyone else but I'd never consider letting another woman wet-nurse my newborn!

Now this is entirely opinion and observation from working with premature infants, many of them who had to be taught how to feed. If these little gaffers whose bodies are so underdeveloped that they're fed by tube for weeks can be taught to alternate between breast when Mom is available and bottle when she's not, why can't normal, healthy infants? If this baby in your post is not gaining at all on breastfeeding alone, the only way that mom is ever going to meet his needs is to feed him continuously for days while he continues to lose weight. That's a little unrealistic. My guess is that the pediatrician said to offer the breast first, until the baby starts getting frustrated, then offer a supplement to "top him up". Too many mothers are being made to feel like failures and bad moms when they just can't keep up with their baby's needs in the first weeks. They're already hormonal as heck and sleep-deprived so let's just make 'em feel guilty and neglectful too, okay?

Umm... climbing down off my soapbox now.

On my postpartum unit I see many moms who do both breast and bottle from early on. Hispanic moms commonly do this. So do moms who have limited time off before they have to return to work. In the babies of these folks who are determined to do both, there seems to be little nipple confusion.

Ten days with no weight gain says something is amiss. Mom could offer breast first, then bottle. After that she can pump to get her supply up.

A hungry, crying kid and fear that her child isn't growing can cause mom's stress level to rise considerably. That alone can inhibit supply.

Formula is not poison. Moms who supplement--especially when baby isn't gaining--are not criminals.

I'd be interested to find out if baby's bilirubin levels have been monitored and how high the numbers have been.