Regarding my case of the 5 month old who did not gain weight due to
inadequate intake, Rachel writes:
I note with some curiosity that this mother had a supply of expressed milk
socked away in the freezer. Ellen, do you know why that milk didn't go into
the baby when it was produced?
Mom had been stockpiling some milk because she is going back to work next
week. I believe that one of the reasons why her milk supply had decreased
is that during many feedings she was breastfeeding on one breast and pumping
the other so that she would have some milk stored up in preparation for
going back to work. What she didn't realize when she started this routine
is that her milk supply was not sufficient to both feed the baby and stock
the frig. And, as a result, the pumping may not have been as effective as
the baby so her milk supply decreased. Also, although this baby seemed
clinically strong and healthy, it is possible that the decreased caloric
intake he was receiving may have resulted in less energy so that even his
suckling was not as effective as before.
And Joy writes:
Ellen, this is an excerpt from:
Cox D, Owens RA & Hartmann PE, 1996, Blood and milk prolactin and the
rate of milk synthesis in women, Exper Physiol 81: 1007-1020
<<We found no change in milk production from month (708 plus or minus
4.7 ml/24 hr (n=11)) to 6 months (742 plus or minus 79.4ml/24 hr
(n=9)) of lactation. Similar milk intakes have been reported for
longitudinal studies in the USA by Neville, Keller, Seacat, Lutes,
Neifert, Casey, Allen and Archer (1988) (range, 739 plus or minus
47.3ml/24 hr (n=12) to 787 plus or minus 24.4 ml/24 hr (n=13)) and
Dewey & Lonnerdal (1983) (range, 673 plus or minus 48.0 ml/24 hr
(n=16) to 896 plus or minus 36.8 ml/24 hr (n=11)).
Joy, I have read the abstracts of some of these studies and I have a
question - Do you know how milk production was measured in the studies? Was
it with 24 hour test weights (which would be the same as figuring out how
much milk the baby is actually consuming)? Or was it some other method that
measured the mother's capability for milk production without knowing exactly
how much the baby was consuming for that 24 hour period?
I guess I find this information a bit confusing. If it is accepted that a
baby's milk consumption should be 2.5 oz/lb/day (by the way one Lactnetter
responded to me privately that this infant feeding requirements info is also
in the Breastfeeding Answer Book), then it stands to reason that a larger
baby would eat more. For example, it would be unlikely that a 1-month old
baby that weighed, say, 8 lbs, would still be eating the same amount when he
reached the weight of 16 lbs at 6 months of age. Can anyone help me figure
this out?
Does anyone know of any research that correlates baby's weight (not age!)
with milk intake? I would personally be very interested in participating in
such a study.
============================================
Ellen A. Steinberg, RN, LCCE, IBCLC
Tarzana, CA
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