Thanks Nikki for sharing Chele's post...
This exactly the contrast I see between LLL type moms and moms in
general...breastfeeding management,
and birthing practices affect when the milk comes in, and the rate of
weight gain in the early weeks...
Sometimes I get the feeling that our profession sometimes wants other
healthcare providers
to have low expectations for weight gain and regaining birth weight for
fear that they will recommend supplementation
which puts an end to breastfeeding...
But the truth is excepting the super bloated baby babies if the baby
hasn't regained birth weight before two weeks of age
there are big problems with breastfeeding...mothers recognize this even
if HCPs don't which is why so many of moms wean before
two weeks of age...
Also I think the range of normal weight gain 4-8 oz per week, is too
low for the early weeks...
In my experience any weight gain under 7 ounces per week once the milk
comes in is associated with other breastfeeding problems...
latch difficulties or mismanagement and/or down regulation due to
sleepy baby...
When the milk is there, and the baby can transfer it, and the mother
puts him to breast frequently day and night I've never seen a healthy
baby gain less than an ounce a day in the early weeks. Babies of LLL
moms double their birth weight around 4 months not six...
I think it might be possible that by educating HCPs about what is
*normal* with non-medicated, non-surgical births,
and with good breastfeeding management, breastfeeding problems will be
addressed earlier...to my mind earlier intervention
will lead to increased breastfeeding duration because when mothers are
helped to overcome breastfeeding problems early,
the problems are more easily solved and the mother gets more enjoyment
out of breastfeeding...
If the mom perceives breastfeeding isn't going well it doesn't matter
how patient the doctor is about weight gain...
I think her reality trumps his perception everytime, so I think we LCs
need to have a handle on what should be happening
not just on what "usually" happens when births are mismanaged, and
breastfeeding is mismanaged...
Jen O'Quinn IBCLC
On Jul 21, 2005, at 7:19 AM, Nikki Lee wrote:
>
> Dear Friends:
> Chele Marmet gave me permission to share her post to me with you
> all.
> -----------------------------------------------------------------------
> ------
> While lecturing in Japan I was invited to visit Okayama National
> Hospital
> which is famous for being the 1st Baby Friendly Hospital world wide.
> When I
> walked from bedside to bedside in the postpartum unit, every baby was
> in bed
> with its mom 24/7. Each mom charted every breastfeed, & urine &
> stool output.
> The highest number of feeds/ 24hr I remember seeing, without going
> back to
> my notes, was 24. They also urinated & stooled very frequently, even
> the 1st
> 24 hrs. What goes in must come out! Of course, these were all
> non-medicated, non-problematic vaginal births. Primips stay in this
> hospital 7 to 10 days
> routinely, so I was able to see that the 5 & 6 day olds were doing
> beautifully. If you heard me talk about this experience, then you
> also heard me say
> that it is our mucked up birthing practices that get babies & their
> mothers
> off to terrible breastfeeding starts & account for our incorrect
> (stupid) ideas
> re number of feedings & breastmilk, urine & stool output to expect /
> 24 hrs
> in the early days. Please quote me again guys. Let's get the word
> out on
> this & get U.S. practices changes!!!!
>
> -----------------------------------------------------------------------
> -----
> warmly,
>
>
> Nikki Lee RN, MS, Mother of 2, IBCLC, CCE
> Maternal-Child Adjunct Faculty Union Institute and University
> Film Reviews Editor, Journal of Human Lactation
> www.breastfeedingalwaysbest.com
>
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