Try reading some of Gill Rapley's work in the UK-Baby led weaning (as in
baby directs the pace of eating food) whilst maintaining full milk
feedings.
I think Nursing first in the first year is a very helpful way of guiding
mums with how what and when and the emphasis on family foods being
complimentary to milk in the first year.
Sue Pace
Midwife/BFHI Coordinator/IBCLC
NZ
-----Original Message-----
From: Susan Burger [mailto:[log in to unmask]]
Sent: Saturday, 29 November 2008 9:49 AM
Subject: Re: Please read posts carefully.
Dear all:
I must admit that I feel quite exasperated at the moment. I do wish
people read what I
ACTUALLY write. No one on Lactnet suggested that anyone who is
concerned about the
over-feeding issue are extremists, not even me. So to put up a defense
to that effect
seems as if my post was completely misread.
I want to make it very clear that what I wrote in my post about Kay
Dewey's work was
that the "ORDER" of which comes first did not make as much of a
difference as the
NUMBER OF FEEDS".
Kathryn Dewey is a well-respected researcher and part of the UC Davis
group that did the
work that ultimately debunked the 4-6 month for introduction of solids
and nailed it to
"around 6 months". Without the work of the UC Davis group we would not
be able to
dispute the introduction of solids excellent work on breastfeeding which
is both copious
and extremely well designed. Therefore, we'd be combatting even more
infants being
stuffed with solids from 4 months of age onward than we already do. She
also worked on
the data that became the basis of the new WHO charts that are now based
on HEALTHY
NORMALLY feeding infants.
I looked up Kathryn Dewey's reference to the study which WAS by Juan
Rivera et al,
1999. It showed that when they promoted 5 meals per day, the
breastfeeding frequency
(per 12 hours) and the breastfeeding duration (per 12 hours) declined
and was
statistically significant among infants 6-12 months of age. In her
presentation at the
Academ, she did not include the full reference, but knowing Juan's work
you will probably
end up with lots of references on infant feeding that would be well
worth reading while
you track down this one particular study showing that too many meals
reduces the
frequency and amount of breastfeeding. This is peer-reviewed evidence
that gives
guidance support appropriate practices that are more likely to IMPROVE
breastfeeding
frequency and duration.
Much of what is written about infant feeding is based on OPINIONS and
THEORIES that
may or may not actually improve the frequency and duration of
breastfeeding in the
second half of the first year of life. Moreover the lack of an impact on
breastfeeding
frequency and duration regardless of whether breast or food was offered
first doesn't
should not be extrapolated into a statement that I never made. NEITHER
KATHRYN
DEWEY, NOR I said that there was anything wrong with offering the breast
first, nor
would I conclude that from the paper.
I do, however, think this research suggests we are likely to have better
results if we
focus more on an appropriate rhythm for spreading out the introduction
of additional
"meals" of solids. Mothers should not be trying to get six month olds to
eat three meals
of solids a day, nor nine month olds to be eating five meals of solids a
day. Focusing on
the gradual introduction of small taste testings and a gradual increase
over the 2nd half
of the first year as well as responding to other physiological cues is
likely to cut down on
the overfeeding that occurs when mothers feel that more meals is
progress.
The similarity between the two situations is not in the enormity of the
consequences, but
in the approach.
Best regards, Susan E. Burger, MHS, PhD, IBCLC
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