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Baby's Name:
Mother's Name:
Date:
Laction Consultant #:
Date Breast - Right Left Urine Stool Supplemental Breast Formula Pumping Other
Feeding (color) (color) Feeding Milk (oz/ml)
(oz/ml) Mins Amt
1
10
Totals
Date Breast - Right Left Urine Stool Supplemental Breast Formula Pumping Other
Feeding (color) (color) Feeding Milk (oz/ml)
(oz/ml) Mins Amt
1
10
Totals
This log is not a substitute for professional lactation advice. Ask your doctor to
recommend a professional lactation consultant in your area.