>  A starving baby are these last posts of babies who have not gained 
>birth weight until 4 weeks and are clearly weak and sleeping too 
>much, etc.


Kathy, I agree that a baby in this position (weak and sleeping too 
much - actually, we'd worry about this whatever the scales said, I'm 
sure) is very concerning.

But it struck me that the only times *I* have been in contact with 
mothers of babies in this position at 4 weeks postpartum - weak, 
sleeping too much, weight gain nil or worse -   I can count on the 
fingers of one hand,  literally. In over 25 years. And in each and 
every case, there was something wrong - serious congenital heart 
problems in one case, and multiple neurological impairment in another.

Now, babies can be in this same position as a result of plain old 
'not enough to eat' - but in the UK I don't see them.  I have been in 
touch with thousands and thousands of mothers and babies, and 
indirectly, via my  students, supervisees and breastfeeding 
counsellor colleagues,  thousands and thousands more. I think it's 
fair to say that the four-week old weak and overly-sleepy baby who's 
that way because of lack of food just doesn't appear to us.

We *do* see them at a week, 10 days, 12 days.

It seems to me that if you guys are seeing these starvers as late as 
4 weeks, and they don't have the sort of congenital problems I 
outlined above,  then there is something different in the care system 
- and of course, we know there is.  By two weeks tops, our true 
starver babies have been picked up by the system.

So I think when people like Nina and me ask questions about the 
benefits/risk ratio of supplementing a weak, sleepy nil-weight gain 
baby, we are not really thinking about the long-term starver....at 
least, I'm not.  I can quite believe that by 4 weeks, the weak, 
sleepy nil-weight gain baby needs *something*, even Rachel's hamster 
milk :), and his mother's milk is probably at a low level so 
expressing will not yield much.

It's  just another reason why *all* women need access to frequent, 
informed and supportive care, which inculudes knowledgable input on 
infant feeding.  Get in soon enough, before a crisis, before the baby 
starts to shut down, and these (potential) starvers can be turned 
round, the breastfeeding can be fixed, the mother's milk supply saved.

Heather Welford Neil
NCT bfc, tutor, UK

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