I really am enjoying the interchanges about infant growth.  This is when
Lactnet is most fun for me because we challenge each other to examine our
beliefs and hold them up against research.  Sometimes our beliefs are
affirmed (for instance, nothing has yet shaken my belief that bfg is best).
Other times, such as when we examine these growth data, we must alter our
beliefs to fit what seems to be coming clear:  The appropriate time for the
most rapid growth in babies is EARLY.  In the breastfed baby, this first 1-3
or 4 months should be marked by very robust gains.  This makes perfect
sense.  You have a very vulnerable, puny, little neonate whose best shot at
survival is to fatten up, get strong, and have lots of energy to put toward
brain growth and health. Later, the best shot for survival is prob. to slow
down and go for the lean body mass.  Breastfeeding will insure this happens,
PROVIDING it goes well.  A case can be made that since the exclusively bfed
baby will "catch-down" (slow growth rate) in the second half of the first
year, those early weeks and  months may be really important in terms of
infants reaching full potential.  As Rachel points out, some of the hormonal
reseach is intriguing in suggesting that growth stress early-on may alter
behavior later. She specifically mentions the preliminary discussions about
depression, but  how many of us have had a starved stray kitten or pup who
never behaves normally about food even once we begin feeding them up?  Do we
know that this anxious behavior is limited to animals?

There is an interesting study about obesity in the new MCN (sort of
horrifying because it never once mentions WHAT the babies are eating as a
variable).  But it talks about low birth weight babies of smokers who then
seem to flip-flop into obesity growth patterns as they attempt (or their
mothers attempt) to catch them up.

So anyway, it is my belief (and I shall have to change it if good science
proves me wrong) that an ounce of prevention is still worth a pound of cure.
We have to begin treating newborns with the same respect older patients
would demand in terms of being evaluated as individuals.   I think that
means giving babies the courtesy of careful observation during the first
week post partum.  You leave the normal ones alone and don't pester their
mothers with pointless, intrusive fidgeting.  But,  you provide PROBLEM
feeders or At-RISK dyads with very specifically tailored early intervention
to protect breastfeeding.   And then you follow these dyads in the community
for a while to make sure that the breastfeeding proceeds normally -- i.e.
robustly.

Barbara Wilson-Clay BSEd, IBCLC
Austin Lactation Associates
http://www.lactnews.com

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