Nina, I am with you....I do not think we have any definitive absolute
answer about how much breast milk each and every baby needs to grow.
The ranges are as much as 400 ml a day and that is quite a range of
normal intake for normal growth. I do wish I had more than the 2.5
times weight per 24 hrs myself since I cannot imagine it is accurate
for all babes.  Considering I birth 13 lb babes, I do not see them
needing 32 ounces of milk a day at a couple of weeks old considering
stomach capacity. So, it does cause me pause when trying to determine
just how much is enough.  The problem is, I rarely see babies who are
doing well.  I do not worry about weighs for sore nipples, but a
thriving baby.  However, I am indeed concerned when a mom reports
adequate diapers and a baby below birth weight at 4 weeks.  So, when I
use my scale and see a milk transfer of 6 mls, I know there is a
problem.

When I see a baby born at 38 weeks who looks perfect at the breast,
and nurse after nurse has assured mom how great he looks, a scale
gives her information she needs.  He may be two weeks old, but he may
not really be off to a good start yet and not all moms know the
difference.  By the time a doctor sees the mom again at two months,
things can get very bad.  I get called because the baby cries after
all feedings and mom cannot calm him with swaddling and a pacifier and
he just sleeps when she tries to nurse again...and mom assures me she
feels sucking.  When I go see for myself, I do not that nice strong
motion of the jaw, though it does appear as perfect as a picture if
you do not know better.  It helps to show her that the thirty minutes
at her breast provided less than 15 mls of milk, and her baby is still
hungry after feeding and that is why he is crying all the time! And
no, swaddling him and popping a pacifier in his mouth will not help!
And, no she is not over feeding him, she is underfeeding him.  Diapers
are not always the best indicator of a well fed baby.  Or my mom with
twins who has limited ability to produce milk who was sure her breasts
were giving her baby ounces of milk at a time...regardless of what I
said...but believed the scale when it said 2 ml after 30 minutes of
sucking strong.  Seeing let her accept the need to supplement and feed
her hungry babies.  If she did not see, she would have maybe continued
to deny them food because of her personal issues about using
artificial milks for her babies.

Maybe we would not need our scales if moms had some understanding of
what breastfeeding should feel like, if all the books did not tell
moms to stretch feeds, encourage long stretches of sleep at night,
swaddle, pacifier, self soothe, etc. Maybe if moms were taught to
trust themselves, to watch more closely, to recognize a cue, etc.
scales could be obsolete.  Unfortunately, I live in a world of 38 week
routine inductions, a cesarean rate that is a crime, and mothers who
are reading too many books that tell them how to disconnect, and not
enough that say the fourth trimester is skin to skin and lots of
feedings.  I wish I did not need a scale.  I wish babies could do as
they please...be born in their own time, as little intervention as
possible and be given unlimited access to the breast, etc.  I don't
live there though, so I need my scale.  I will admit however that I
would like more to go on than the formula we use to determine intake
needs.  For now, I go with as much as your baby asks for...not to be
confused with as much as your baby will take...until we see some
weight gain, an increase in milk supply and a baby who shows us that
the sucking is for milk not just pleasure.  I am not sure we can know
that since all babies are so different and the range of normal cannot
tell us what the individual baby we are looking at will need.  That
would make things easier though....an absolute amount all babies need
to eat at every feeding to grow the exact same way in the exact same
time. Shame babies are all so different and make our work so much
harder! <big smile>

It helps to remember too that those of us using our scales are not
seeing happy, thriving babies with mothers enjoying pain free and
pleasant feedings.  If we are being called, something is not right. A
scale is just a tool to help have a full picture of all the possible
issues to work with.

Take care,
Pam MazzellaDiBosco, IBCLC, RLC
Florida, USA

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
Mail all commands to [log in to unmask]
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or [log in to unmask])
To unsubscribe: unsubscribe lactnet or ([log in to unmask])
To reach list owners: [log in to unmask]