Teresa you asked: >What should we be telling parents about weight gain in
their
babies? When is supplementation necessary?<

I think the last question is particularly interesting.  Necessary for what?
I don't think we, the literature, society in general, etc are very clear on
this.  Necessary to stop the baby dying?  Necessary to prevent the baby
deviating downward from the line on the weight chart -- which may be a
cross-sectional population standard chart, based on babies not only fed
wholly on breastmilk substitutes from birth, but fed on substitues available
20 or more years ago..... ????  Between these two different goals lie a host
of other 'cut-offs'.  It is just generally accepted that 'growth=good' is
very uncomplicated and that there is no real difference between the two
different measures above.  [and there is, of course].

And what would you factor in to any way of assessing the risk of some weight
'faltering' of any individual baby?  His parents' body size?  His mother's
history of atopic disease?  His exposure to various pathogens? The growth
pattern of his full siblings?  What kind of milk he has had since birth?
What style of (breast or bottle)feeding (exclusive, mixed, semi-on-demand,
scheduled) he has had??????  And what 'formula' do you use to calculate the
relative 'weight' (sorry about the double meanings here!) of the different
factors?????

It would be nice to think that anyone is really looking at this
intelligently ( in some kind of study), but I have just about lost my faith
in that possiblity.

Magda Sachs
Breastfeeding Supporter, BfN, UK
Research Student, University of Central Lancashire

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