Dear all:

I think we do have a responsibility to FULLY assess a situation when a baby is not feeding 
well.  This requires looking at all the indicators at our disposal with the best means 
possible within our capacity. 

Intake, energy expenditure and growth really fit more into chaotic theory than into any 
linear equation. Health requires robustness and flexibility of the dynamic systems of the 
body. So anyone trying to fix a linear equation to these parameters is doomed to fail. 
"Nonlinearity in feedback processes serves to regulate and control."  

This means that in a normal healthy situation, if intake is decreased a bit, the body 
compensates by reducing energy expenditure.  Or, if energy expenditure increases, 
appetite increases.  Or if growth increases, appetite increases.  And there is a constant 
ebb and flow that maintains health.

What I think a good clinician tries to do is to predict whether or not the ebb and flow of 
this dynamic system is predict whether "a small change in one parameter will push the 
system into an otherwise unhealthy" state. And this requires looking at it as a system, 
not separate bits of information.

The answer is NOT rejecting one piece of information because, by itself, that piece of 
information is insufficient.  That piece of information may be NECESSARY BUT NOT 
SUFFICIENT RATHER THAN INADEQUATE.  The answer is to look at the bits of information 
as a whole and determine whether or not the chaos of a healthy state has been disrupted 
or is likely to become disrupted. 

This means, one cannot just collect information on intake alone (however you choose to 
collect it).  I would argue that those who do not collect weights are simply choosing 
another method (which may be fine in some circumstances) of judging intake --- whether 
it is swallow patterns, infant behavior, or any other myriad of observations one makes 
while watching a feeding.  One feeding is not enough even for these types of 
observations, it must be grounded in the fuller picture of frequency, duration, rate  etc.

And I would argue that in order to prevent use of formula unnecessarily, we should be 
looking at all the means at our disposal to PREVENT the dynamic system of intake, 
energy expenditure and growth from being disrupted into an unhealthy state rather than 
patching it up after it has gone into an unhealthy state.

Best, Susan Burger

Who wishes she understood mathmatical systems better or could induce a mathmatician 
to look at infant growth in the same manner that mathmaticians are now looking at heart 
rythms.

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
Mail all commands to [log in to unmask]
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or [log in to unmask])
To unsubscribe: unsubscribe lactnet or ([log in to unmask])
To reach list owners: [log in to unmask]