Hi Magda - Colin is an Aussie.  I have heard this concern before.  I think
it is a cop out for three reasons.  First, I think it is when babies' growth
begins to plateau after the third month that mothers are often pressured to
supp or to introduce solids because the babe's growth is 'faltering'.
Education for HCPs is key here.  Second, because mothers rarely decide to
'top-up' all on their own.  They are usually advised to by a health care
professional.  Mother's concern that a baby's weight is following a centile
that falls below the mean can be reassured by health professionals who are
knowledgeable and well educated.  It is only when the HCP concurs that the
baby is in need of supplementary nutrition that she will use 'top-ups' as
instructed. And thirdly because the only answer that seem to be available in
the tool kits of very many health professionals is the 'top up'.  I have
never ever heard a mother tell me that her Child Health Nurse, GP or Paed
has advised her to feed more often, switch sides frequently during feeds,
express after or between feeds, wake the baby at night to feed, use EBM to
top only if the baby is not satisfied and then use cup feeding or paced
bottle feeding.
I guess I have another letter to write.
Nina Berry BA/Bed(Hons) Dip Arts(Phil)
Breastfeeding Counsellor
PhD Candidate - "Ethical Issues in the marketing of 'Toddler Milks'"

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