<<  Dysfuctional feeding is
 promptly recognized as a crisis in the elderly, or even in animals, but it
 is frequently ignored in infants.  I don't understand this >>

having just returned from my local lactation journal club, where we discussed
new infant/child growth rate charts, hotly awaited - not good, baby's weights
were generally up overall over the old ones! our hopes that these would
better reflect the differences in growth rates between formula fed and breast
fed infants seems to have been dashed, some comment was made that "breastfed"
for the purposes of this chart was only 0 - 3 months. now the idea is to
await the WHO growth charts which are expected to better reflect what we
"expect" as normal in breastfed babies.

then it was on to a discussion of the new AAP guidelines about hypoglycemia
and the ABM (academy of bf medicine) guidelines. they are not completely
continguous with the WHO guidelines (which for instance point out that
healthy SGA infants should NOT be tested for hypoglycemia). i asked "why is
the local practice so wildly different from these guidelines?"

leave it to me to ask the embarrassing questions; i was told it was probably
due to "our litigious society" and "someone probably won a lawsuit once over
a baby with a poor outcome" - and then of course the topic was quickly
dropped. these aren't the reasons, though. its the persistent belief that
using a bottle of formula is MOST APPROPRIATE to fix the "problem." when oh
when will there be a frightening lawsuit over inappropriate supplementation?

which brings me to barbara's rhetorical question (hey, i know whereof i rhet,
i have a COLLEGE DEGREE in rhetoric) and i feel compelled to believe that the
only answer to this question is that we have a tremendous misapprehension
about the nature of infants (to wit, constant comments about "he's
stubborn/he's lazy, he won't nurse - when what is truly meant is that the
baby can NOT nurse) and our firm conviction that all can be fixed with a
bottle of formula. really! i think this is the cause of a great deal of
medical blindness. we think babies that don't breastfeed have an attitude
problem, and its no big deal to fix it with a bottle of formula.

barbara's right; with an elderly person, no one ever says "she's a stubborn
old coot, we'll just starve her out." no, first she gets a medical workup to
see if there are underlying problems causing a refusal to eat (which is
really an inability to eat). yes, eventually it may be that the person in
question IS refusing to eat from choice, but we can't accuse a newborn of
making a volitional decision to not eat. and no one ever says, oh heck, just
go to artificial feeding, if there is any chance of preserving normal feeding
patterns (except with babies).

what is it that frightens people so about babies?

carol brussel IBCLC

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