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Sent: Friday, June 20, 2008 6:49 PM

Subject: Re: [LACTNET] LACTNET Digest - 19 Jun 2008 to 20 Jun 2008 - Special issue (#2008-687)

 

**Hi Vicky,

Thanks for the responses. Maybe I'm one of the ones who get "3 hrs." in mothers minds. But what I tell them is not to feed any less often than ev. 3 hours so I don't hear "He's so good he slept 4.5 hours today".

 

**Sometimes I discuss this vocabulary with mothers: the whole idea of babies being 'good' is not about the number of hours in between feedings. The idea itself should be abandoned, regardless of whatever behaviour is going on. In my opinion, *all* babies are good. Some are simple more at ease with their new way of living (i.e. extrauterine instead of intrauterine). I don't feel like agreeing with moms who say their baby is good. As soon as we confirm that they are good, we implicate that with different behaviour, we could qualify them a 'not good' or worse: 'bad'. I do my utmost to prevent this way of thinking about babies.

 

I definitely don't believe any baby, at any age, should be held to a 3 hr. schedule in spite of cues that signal hunger. He may be in a growth spurt or didn't feed well last time, or there may be insufficient milk supply or any number of reasons. 
Moms, often in the beginning, can't tell the difference between hunger cries, tired cries and "I want to be held" cries.

 

**Vicky, is it of importance to you and do you think it should be of importance to mothers, to be able to tell the difference...? All cries mean the same: "Mom, I'm not happy." And for a breast fed baby, almost all unhappiness can be resolved in the same way: at breast.

 

Often about half an hour after feeding, babies get tired and want to go to sleep. They cry and suck their fists as if hungry. Mom puts a "ravenous" baby to breast, a couple sucks later he's asleep and she's confused.

 

**This is a physiologic process. Sucking at the breast brings milk and when done in the right way, also elevates oxytocin levels in the baby. When fat and protein enter the intestinal tract, cholecystokinin (cck) is released and helps digestion along. The hormone cck causes satiety and also causes the release of oxytocin. Satiety and oxy together make the baby sleepy and that is why an infant easily falls asleep at the breast. He may wake up soon after, be awake for a little while and fall asleep again after a few sucks. The mother doesn't need to feel confused: we can explain this physiologic process to her and she can feel confident and proud that her bodily closeness works such wonders for her little one.

 

When moms put babies to breast every time he cries he often, over time, gets over fed and gassy. Mom complains that he wants to nurse all the time and says she must not have enough milk, often supplements him "just in case" and she gets worn out.

 

**If she thinks that, lc's have a wonderful job ahead of them to explain the way lactation works and why babies react the way they do.

 

If babies nurse on one side and half the other side and burp between and are stimulated to stay awake during feedings, and can make it to the next feeding, their moms can pretty much tell they are getting enough to eat. Especially if he is pooping and peeing enough. they can often slip into a three schedule which seems to work better for moms who want to nurse but have busy lives. Obviously preemies need to nurse as often as they strength to do so.
My question "do babies need no more than about 4 ounces even when they are 6 months old because of changing composition of breastmilk" was more in reference to (and I think I didn't make it clear) how much they can expect to give a full term baby when they're  pumping and bottle-feeding breastmilk. Some think one goes by the "2.5 times the body wt, etc." even when baby's older. 
And by the way, maybe this will start a thread about whether schedules are right or not but I sure have found that busy mothers need some sort of schedule in order to feel confident about their milk supply and get some time to eat, run to the store, etc. and it usually changes some as they go along, but it's a base for them.

 

**I think this is a highly culturally influenced thing. The thought that mothers 'need' some sort of schedule can also be an opportunity to talk about how that need came along and whether it really makes life easier or in fact more complicated because you have to stick to that schedule. Admitted, dinner needs some time to get prepared, but for most other meals during the day, they can be enjoyed while feeding. I had the majority of my warm meals with a spoon, while I had a daughter in my other arm at the breast. At schooldays, I prepared sandwiches for the older three at lunchtime and when they were all eating, I would eat my own lunch with a baby suckling. Life was busy with for small ones, but I learned to accept that. That really is a gift we can offer moms: the wisdom that life cannot remain the way it was, that life and baby don't need to adjust in order for us to keep as busy as we were before. Choices come with consequences and slowing down with a baby is necessary. We cannot rush carry-offspring into cache-young-behaviour. Our milk has not adjusted as far as fat and protein percentages are concerned and neither has baby-brain-capacity at birth. They need us around, at short intervals, and not just for calories.

 

And when they know he gets a good feeding about every 3 hours they then know that he's crying for another reason and they have faith in their bodies and understand baby better.

 

**Putting it this way, to me, makes the whole thing of caring for a baby look like a (power) competition: "I know you can't be hungry, so it's not my fault that your crying." I don't even get the meaning of how we can more easily have faith in our bodies if our baby cries for something other than hunger... :-s In what way does that help to understand our baby better...? Just the other day, I heard or read about the difference between stomach-hunger and... what was it... body-hunger? Heart hunger? Mama-hunger? It might even have been here on Lactnet, I don't remember, but the breast is a miracle: it can satiate both or all kinds of hunger, regardless of time of day or number of calls for consolation. If it drives us nuts, we could use some therapy, either from a therapist or from a good friend, who poors us a big cup of tea, sits us in the shade in the garden with a refreshment and spends some quality time with us. That truely helps melt the worries away, not because our baby behaves differently, but because we respond to it differently.

 

I also tell moms babies often have one long stretch of sleeping and it's better if that takes place at night time, for obvious reasons. So I tell them to wake baby up every 3 hrs. if he is sleeping so he won't do the long stretch during the day. Also when moms leave babies with babysitters who aren't familiar with babies cues

 

**But would that really be a wise thing...? Wouldn't we rather advise parents to make sure their babysitter *is* able to read baby's cues...? I usually prefer problem solving to symptom fighting. Everyone is better off, when the problem is solved. In this case, not being able to read baby's cues is a real problem and it exists throughout society. Sometimes I even wonder whether we, as lc's, are not constantly behind schedule, because we try to solve problems that, in the first place, arose because of the societal problem of lack of knowledge about baby behaviour and baby needs...

 

they need to be able to leave them a certain amt. of pumped breast milk to be fed every so many hrs. so as not to waste the milk by over feeding every time he cries instead of trying other things such as swaddling, wearing baby, etc. I don't think schedules are such demons.

 

**I wonder if we should not strive for *inner* schedules instead of *outer* schedules. It is somehow like people who watch the clock first, when you ask whether they would like a cup of tea or coffee. Or you offer the next cup and they say: "I already had two cups." "So what...?" I would say. That goes for a baby, too. Does it really matter what time it is or how often s/he was fed until then...? I don't think so, and most certainly not with babies that are a couple of weeks old. I'll hand in a article to this extent beginning next week and really hope to help a discussion get started in the Netherlands about trying to get babies to fit into our schedules; it most certainly is not what Kathy Dettwyler advocates in her biocultural perspective on breastfeeding, as far as I understood her work...

 

Warmly,

 

Marianne Vanderveen, Netherlands

 

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