I wrote this:

>> So, pick your poison -- would you rather have some children supplemented
>> when not necessary, or would you rather have some children not supplemented
>> (or not have their problem fixed, whatever it is) when it is necessary.

And Catherine Watson Genna wrote this in reply:

>Of course, we'd rather have good accurate studies that tell us what's
>normal, and we'd rather have breastfeeding assessed by an LC if there
>are questions about growth in an OTHERWISE HEALTHY older baby, before
>other specialty consults.  I don't think trying to fix the breastfeeding
>first if there is mild weight gain faltering will put children at risk.
>I agree that it is just as dangerous to ignore all growth issues as it
>is to over-react.

Catherine, we agree.  I wasn't saying you shouldn't try to fix the
breastfeeding first is there is mild weight gain faltering, before going to
a specialty consult.  I was saying that what I see/hear are people
dismissing any weight gain faltering in a breastfed baby as being just due
to the baby being a breastfed baby and not doing *anything* to fix it.  Not
sending the mom to an LC for a consult, not checking to see if the latch is
proper or the baby is suckling effectively -- rather, just chalking it up to
"Well, the weight gain is faltering, but that's because this is a breastfed
baby, so we won't worry about it."

As always, the growth charts, regardless of where they come from or what
population they are based on, are just one tool, and can be used, abused,
misused, or ignored.

Kathy Dettwyler

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