A friend of mine, colleague actually as well, had an experience recently
where her 4th child, 6 1/2 months, totally breastfed, was assessed by a
nutrition student at a local university. This is a synopsis of that
student's assessment of the nutrition of this infant, Spencer. Thought it
would be interesting to comment on.
Please send comments to the list and to me at [log in to unmask] Thanks.
_________________________
From my friend..she writes:
I just have to write to someone to tell about this experience!
I was contacted by a xxx Nutrition student, John, to do a
nutrition assessment on my infant. I said okay, but he just receives
breastmilk. That was fine, I was told.
Estimating the intake of breastmilk was difficult. At the
time of this assessment, Spencer is 6 1/2 months old and nursing
exclusively. He is a snacker, though, sometimes only drinking for a
few minutes. That's typical for my children, though; all have been
quick nurses at this age.
So I give John, the student, the times and durations of feeds, and he
estimates the time to be 70 minutes total for a 24 hour period, ie freq.
short feeds.
In his report, the student writes:
"With the above given information it was not possible for me to
determine grams of breastmilk consumed during each feeding. As a
result I was forced to estimate daily intake.
"Six month old infants who are breastfeeding consume between 335 to
1144 grams per day, with an average consumption being 770 g/day.
These figures aare based on infants whose diets also include
semisolids to meet part of their caloric needs. Because Spencer's
diet is still solely breastmilk his consumption per day will need to
be higher than the average of these infants studied.
"Therefore I estimated Spencer's consumption to be near the high end
of the range at 1000 grams of breastmilk per day."
And then, in big red letters the instructor (I assume) wrote, "THIS
KID'S GOTTA BE HUNGRY!!" (Hungry underlined twice!! no less!)
In the written report:
"It is notable that Spencer is six months old and still consuming
nothing but his mothers breast milk. Another important note is that
an estimated amount was used for Spencer's consumption for this
evaluation. This was due to the difficulty in determining the amount
he actually consumed while breast-feeding. Therefore, this analysis
itself is only an estimation.
"Upon analyzing the data, it appears Spencer is lacking in his
Recommended Daily Allowance (RDA) for four categories; total
calories, calcium, iron and zinc. Looking at Spencer's growth
charts they show him to be within normal ranges for all. However,
one does stand out due to a drop in his percentile rank over the last
two months. Spencer has dropped from the 75th down to well below the
25th in the chart plotting his length against his weight. Although
he is still within the "normal" range for the population, he has
dropped below normal for his own previous growth rates. It is
preferable that children maintain his percentile ranking and a drop
of 50 percentiles is significant.
"It is advisable that Spencer be started on semisolid foods.
Although breast milk is very good source of nutrients for infants, by
six months their overall caloric needs may surpass what they can get
from milk alone. The need for additional sources of iron at this
time is standard. (Instructor notes: "good") His need for additional
calories and iron can be met with the incorporation of an iron
fortified baby cereal; one to two baby spoons two times daily. To
support the caloric needs as well as the need for additional zinc it
is recommended he be started on some strained vegetables such as
beans (zinc) and dark green vegetables like spinach (iron); same
feeding schedule as cereal.
"These aforementioned additions to his
diet along with the breast milk should bring Spencer's intakes up to
his RDA's. Consequently, his rate of weight gain should increase
bringing him back near the percentile ranking he started in and held
through the first four months.
"The results of the analysis may be in error due to the estimation
of Spencer's intake of breast milk. Although his dietary intake that
the recommendations are based may not be accurate, the
recommendations are still advisable based on accepted standards in
the nutrition field."
(Instructor: "Very good!")
Naturally, I noticed that the growth charts are from Ross Laboratories and
have Similac and Isomil written all over them. I'm glad my baby is so
"undernourished" because if he were any
heavier than the 17 or so pounds he is now, I would not be able to
carry him as much as I do currently.
I didn't mean to type the whole report in, but I had most of it
done before I realized it! They may be correct about this, but I
don't think I'm starving my baby! And this is information he will
give to another breastfeeding mother as soon as he graduates. So
heat up that cereal, mama!
I'd love to hear your take on this, Kathleen. I have half a mind to
show this instructor my "starving" baby.
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Comments? Kathleen
Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet,TLC, Indep. Consultant
http://together.net/~kbruce/kbbhome.html
LACTNET Archives http://library.ummed.edu/lsv/archives/lactnet.html
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