Cathy remarked:  "I would however like to say there are extreme difficulties
in assessing
"feeds/day" in any research study. The question of defining exactly what
equates to "one breastfeed" is a nightmare faced by many breastfeeding
researchers (often only realised post data collection) and should always be
clearly stated in the methodology (although I must say I have certainly been
guilty of not doing so)."

I have just got hold of a study which is a real model in this regard and
which I recommend to all of you for a variety of reasons:  Hornell, A,
Aarts, C Kylberg, K, Hofvander, Y and Gebre-Medhin, M (1999) Breastfeeding
patterns in exclusively breastfed infants: a longitudinal prospective study
in Uppsala, Sweden.  Acta Paediatrica 88 203-11.

In this study, which looks at breastfeeding style (as per Sara Quandt) in a
cohort of exclusively breastfeeding mothers,  they define 'one breastfeeding
episode', 'expression of breastmilk' 'expressed breast milk', 'taste' [of
any liquid or food], 'daytime' and 'night-time', 'feeding on demand', and
'exclusive breastfeeding'.  I cannot, off hand, think of anywhere else I
have seen explict definitions of all of these.They go on to analyse all
kinds of variables in the data -- frequency of feeds, frequency of night
feeds, day-to-day variation in suckling frequency of individual babies,
changes in suckling pattern/duration over time, inter-feed intervals, and so
on, for this cohort of women.  "The most important findings in the present
study were the wide variations in breastfeeding patterns, both between
individuals and in the same individual over time."

Magda Sachs
Breastfeeding Supporter, BfN, UK

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