Ellen Steinberg wrote:
>I think that it is very important for lactation consultants to have a gauge
>for milk supply volume. Since most of the mothers I work with understand
>ozs better than kgs, I use the requirement of 2.5 oz/lb/24 hour day. (This
>translates to 90-120 kcal/kg/24 hours.) Biancuzzo and others have reported
>that this is an appropriate intake for normal, healthy babies under 4
>months of age. I am not aware of specific guidelines for babies over 4
>months of age. If anyone has research on this, please share.
Ellen, this is an excerpt from:
Cox D, Owens RA & Hartmann PE, 1996, Blood and
milk prolactin and the rate of milk synthesis in
women, Exper Physiol 81: 1007-1020
Note: This article is primarily about level of
prolactin and how it declines despite maintenance
of milk supply. Quote from page 1016 in the
discussion:
<<We found no change in milk production from 1
month (708±54.7 ml/24 hr (n=11)) to 6 months
(742±79.4ml/24 hr (n=9)) of lactation. Similar
milk intakes have been reported for longitudinal
studies in the USA by Neville, Keller, Seacat,
Lutes, Neifert, Casey, Allen and Archer (1988)
(range, 739±47.3ml/24 hr (n=12) to 787±24.4 ml/24
hr (n=13)) and Dewey & Lonnerdal (1983) (range,
673±48.0 ml/24 hr (n=16) to 896±36.8 ml/24 hr
(n=11)). However, concurrent prolactin
measurements were not made in the earlier
studies. In the present study, while milk
production remained relatively constant until 6
months of lactation, the concentration of
prolactin in plasma declined. This is consistent
with Huang et al (1987), who reported that
between 40 and 60 days postpartum there was no
change in milk production (1160±102 and 1125±108
g/24 hr, respectively), while there was a decline
in the concentration of prolactin in the plasma
[figures of prolactin] in mothers selected from
groups of women on the basis of 'adequate' milk
volume. Therefore, 24 hr milk production was not
controlled by either the basal or
suckling-stimulated concentration of prolactin in
the blood.>>
I think this clearly shows that this knowledge
has actually been around quite a while - just not
amongst non-researchers, such as lactation
consultants - that a baby's intake *does not*
increase correlated to body weight.
I am not disputing your clinical judgement that
the particular baby to whom you refer is not
getting enough milk to grow - just that the
calculations you quoted are not necessarily
accurate.
Joy
--
**************************************************************************
Joy Anderson, South Eastern Suburbs Group WA. Counsellor since Jan 1987.
Married to Keith, kids Craig (1984) and Keryn (1987).
Group treasurer, group projects (name and address
stickers; Helpline and library stickers), local
assessor, convenor of Breastfeeding Resources
Portfolio, member of Booklet Revision, Approval
and Proofreading, Website and New Breastfeeding
Information Working Groups
mailto:[log in to unmask]
'Never forget... breastfeeding is a confidence trick.' - WHO handout
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