I find the whole idea of getting a mother to do this pump test really
uncomfortable.

It's focussing on numbers and times and quantities that got the West into
this whole mess with infant feeding anyway.

Quite apart from the accuracy of this test (or potential for innaccuracy),
it doesn't matter a jot if the mother produces 5 litres a day. It's what
gets into the baby that counts, coupled with his needs, which are
individual.

I have posted the reference to this study more than once on Lactnet and I
think we should all know about it :)

KENT, J. C., MITOULAS, L. R., CREGAN, M. D., RAMSAY, D. T., DOHERTY, D. A. &
HARTMANN, P. E. (2006) Volume and Frequency of Breastfeedings and Fat
Content of Breast Milk Throughout the Day. Pediatrics, 117, e387-395.

Shows the volume of milk taken at any one feed in *healthy, thriving
babies* varies between 0 ml and 240 mls .
Shows how individual babies are.

So even doing a test for four hours is not going show the true picture.
The babies in the study will not have taken all the milk that was produced
anyway.

I have never heard of anyone actually carrying out this test, and if a
mother told me she was being asked to do it, I'd be quite shocked.  I'd
assume anyone informed would be doing this test alongside a whole load of
other observations that made the test irrelevant - so why do this invasive,
undermining and uncomfortable test anyway? Makes the mother into a lab rat.
How will that make her feel?

Heather Welford Neil
NCT bfc, tutor, UK




On 11 July 2013 09:35, vgthorley <[log in to unmask]> wrote:

> Great post, Nina. I tell parents that numbers aren't the key thing, but
> observing theitr baby is - and that if I gave a figures, it would show that
> I didn't really know anything. Sure I can keep in mind a range. but not
> dictate what THAT baby "should" take at THAT feed.
>
> I explain:  How does a mother know that her baby is getting enough?
> Observations, including growth, not numbers.  How does a a mother whose
> baby is bottle-fed some or all of the time know if s/he is getting enough?
>  Exactly the same, i.e. it should be based on the well-being and growth of
> her baby, not mere numbers that don't take into account individual
> variation.  If what is in the bottle is an artificial mixture made up from
> powder, she doesn't really know what is in the bottle, numerous studies
> having shown variation in making up the same recipe. If the mother is
> breastfeeding, yes, feeds will not be uniform, but in normal circumstances
> her body will interact with her baby and adjust the fat content and volume
> through the 24 hours (provided there is unrestricted access to the breast
> and a vigorous infant, and ruling out less usual maternal physical or
> endocrine anomalies).
> Yes, I hear what other posts have said about the test that was cited, but
> my concern is that it is open to misinterpretation, and may not applied
> appropriately. If used, it would need to be part of other observations. I
> also acknowledge some posts have wondered what is being done about Rule 1
> (Feeding the Baby) during the four hours of the test.
>
> Virginia Thorley, OAM, PhD, IBCLC, FILCA
> Brisbane, Australia.
>
> Nina Berry wrote, on the question of the 4-hour pumping test:
> "Won't tell you anything about an infant's intake, though - and I would
> have thought that intake has a much more direct bearing on whether or not
> an infant thrives.
> Surely the issue is enough intake or not enough.  Since we don't actually
> have any good evidence of what number constitutes enough for any given
> infant (given there is such a wide range of volumes upon which infants have
> been observed to thrive), we have to use the clinical signs to determine
> whether any given baby is consuming enough.  The number that corresponds
> with enough for one infant may well be not enough for another.  Numbers, in
> this case, are a distraction and could well become a hindrance."
> Nina Berry PhD
> Australia
>
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