To the best of my knowledge, the idea of a growth spurt at 4-6 mo is a
discredited notion unsupported by the clinical data which indicates that
baby's actually have lower energy requirements during this phase of
development than immed. postpartum when growth tends to be quite rapid.  I
think what we see at 4-6 mo. is moms who are having more freq. separations,
less breast stim.  Babies are expressing, I think, distress over separation,
thirst, impatience with slow let-down from harried moms, and the flow rate
from these understimulated breasts competes poorly with the rapid flow rate
of bottles.

 I counsel moms at this point to pump more at work so their fuller breasts
have a more accessible supply.  I suggest they leave some "thirst quencher"
bottles with sitters consisting of just an ounce or so for a between meal
pick-me-up.  Two to three hrs is a long time to wait to wet your whistle,
and most adults couldn't comfortably go that long without a drink.  So the
complaining baby who is in care or even with mom needs that access.  At this
point  pp many moms are frustrated with what they view as too much demand
for unreasonable amounts of nursing.  They think the baby is too old to
nurse freq.  When I point out the thirst need they immed. understand and
say, Oh.  Ok.  These are usually such brief sessions at breast anyway, but
they cont. to be safer to the child's immature gut mucosa than tap water
(which even in cities such as Austin and Sidney have had probs. with
parasites or other contaminants in the municipal water supplies).

The other issues we may have less control over -- particularly the child's
separation distress.  I counsel about the benefits of co-sleeping, cutting
back on optional work-related or social committments until the baby is
older, the transitory nature of the young child's needs in comparison with
the long-term emotional stability investment etc.

Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.jump.net/~bwc/lactnews.html

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