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From:
Winnie Mading <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 7 Feb 2008 09:49:16 -0600
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"if you are seeing babies gaining just five ounces a week in the early weeks there is a problem".

This statement cought my attention also.  My problem is with the word "IS".  It's not only docs that immediately say something is wrong when a baby doesn't match some predetermined criteria.  We can be just as guilty of it.  Certainly we know that there are averages and that while most babies will fall within those averages, others will be outside them without it being a problem.  We, also, have to be careful not to say things like, "If baby doesn't have at least X wet or dirty diapers there IS a problem." or "If baby doesn't nurse at least X times in 24 hours (or more times than X in the same 24 hours) there IS a problem." or "If baby doesn't gain at least X weight in X period of time there IS a problem." etc. etc. etc.   When a baby falls outside any of these parameters we need to think, "this MAY indicate a problem".  Then we look at the myriad of other factors including baby's general overall behavior, development, health etc.   I think many times we do this without involving any drastic thinking or plan as we look at all aspects of the baby in total.  When everything else looks "normal" we are more likely to think that while a certain parameter is outside the average for babies in general, it may well be normal for THIS baby.  We might follow that parameter a little more closely for a while to be sure since in a few cases it COULD be an early indicator of a problem, but in the vast majority of situations, if all else is "normal" it is likely just a different norm for this baby.

I am wary of any absolute terms such as "will" "must" "never" "is" etc.  One of my favorite expressions, and one I have used in clases many times is, "The only absolute is that there are no absolutes!"

Winnie Mading

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