It is definitely not only in Manhattan.
It is the same here - almost every time I hear the same story, in the discussion that follows it gets clear that baby is very distractible during the day and snacks at the breast instead of properly feeding and is sleeping for 8 to 10 hour stretches in the night even if mom is not scheduling feedings.
So it is always a good idea to have mom check how many feedings there are during the day and if baby sleeps for longer stretches in the night.

Christina in Bulgaria
BF Peer Counselor

--- On Fri, 2/27/09, Susan Burger <[log in to unmask]> wrote:

> From: Susan Burger <[log in to unmask]>
> Subject: Re: Four month old dip
> To: [log in to unmask]
> Date: Friday, February 27, 2009, 3:04 PM
> Dear all:
>
> Perhaps practices are different in your subcultures, but I
> always have to remind myself to
> check how often mothers are breastfeeding or draining their
> breasts when I get the call
> with "my baby is four months old and I'm losing my
> supply".  I still can't quite wrap my
> mind around how abnormal infant feeding practices are here
> in Manhattan.  There are at
> least two lay books that suggestion feeding 3-6 month olds
> only 4 times per day.  There
> is one pediatrician who recommends 12 hours per night
> sleeping --- which gives you only
> 12 hours to get in the 8-12 feeds per day that would be
> normal.  Even if a baby is taking
> only 6 feeds -- that means feeding every 2 hours within
> that 12 hour stretch.  Yes, in
> most of the literature I ever read that was admittedly
> developing country data 8-12 feeds
> per day was STILL NORMAL.  I've been plenty of babies
> who, in Manhattan culture, will
> appear to drop down to 6-8 feeds per day in the 3-6 month
> range with no apparent
> adverse effects, but once it dips down below that --- I see
> the milk supply crash.
>
> I've become so tired of the "oh, but I read such
> and such and my baby seems fine on 4
> feeds a day" that I now explain in the prenatal
> breastfeeding class why no baby should
> ever eat less than 5 times a day --- by comparing it to
> toddlers who need three meals
> and two snacks and how toddlers have bigger stomachs than
> babies.  And I explain that
> while you can stretch a stomach (like the Japanese guy who
> mostly wins the Nathan's
> hotdog eating contest in Coney Island) it is not a healthy
> way to eat --- opening the door
> for later eating disorders.
>
> So, while working with the 4 month milk supply crash, I
> highly recommend you
> investigate whether or not it is due to an abnormally
> infrequent feeding schedule first.
> While I have seen other causes --- I'd say that 95% of
> the time it is the feeding schedule.
>
> Best, Susan Burger
>
>
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