Susan Burger wrote: 'Seriously, since when has 5% weight loss been considered a "serious risk of developing a problem"?'

The criterion was 5% weight loss *in the first 36 hours*, not all babies with 5% weight loss. The authors picked this particular criterion because previous research showed this sort of more rapid weight loss to be a predictor of a higher likelihood of going on to further weight loss. Interesting comment from one of the study authors on Alison Steube's post, at http://bfmed.wordpress.com/2013/05/13/early-limited-data-for-early-limited-formula-use/#comment-2413, explaining this point and also clarifying an important point that was unfortunately left out of the study - namely, that all women in the study did indeed get intensive breastfeeding support, and that this wasn't just a case of "here, try this formula/try these soothing techniques" for women having difficulties.

With regard to the question of effects of a little bit of formula, I'd be interested to know if you have any *outcome* research into this. Yes, I'm aware that studies have found changes in newborn gut flora associated with formula supplementation and that this raises theoretical concerns, but, as yet, the only studies I've seen into outcomes are the allergy studies which seem to be a bit too contradictory to draw firm conclusions from as yet. So, if you know of others, I'd love to know of them.

Meanwhile, looking forward to hearing more about what you felt the statistical problems with the paper to be.


Best wishes,

Dr Sarah Vaughan
MBChB MRCGP

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