Dear Friends-

I've led an evening LLL groupo for years.  Virtually all the mothers who
attend work outside the home, either part time or full time.

Their babies cover the full spectrum--from skinny little things that
look like they'll break in half to big chunky butterballs.  In
individual cases, I have discussed how to increase or decrease hindmilk
and how to increase or decrease total intake and how to get a caregiver
to feed more often or to offer other comfort besides food.  Overall, I
don't think these babies are any thinner or fatter than the ones I used
to see in my day group where almost 100% of the mothers were at home
full time.  Babies come in a variety of shapes and sizes, whether their
mothers are nursing ad lib at home or pumping at the office and nursing
when they get home.

There is one class of children who are an exception: these are the
babies who are nursed and then bottlefed, with abm if there is no
expressed breastmilk on hand, until the baby is "full". A variation is
the baby who is bottlefed ebm, then given abm unless the baby can't sip
another slurp.  Some of these kids are unbelievably obese and they are
proof that you CAN overfeed a "breastfed" baby if you also use bottles,
esp. ones with abm in them! These kids are as likely to belong to "at
home" moms who spend their days in the mall, where they  bottle feed for
modesty, as they are to be kids whose mothers are at work and whose
caregivers stick a bottle in their mouth every time it opens.  Actually,
it is a lot easier to help a working mother realize what is happening.
If she is pumping 35 ounces a day to cover the 10 hours in daycare and
the caregiver is using a 24 oz can of abm on top of that, it is clear
that the 4 month old is being overfed.  The "at home" mother is more
likely to protest that the baby "doesn't get enough from me." Besides,
she, not the nanny, is the one who has adopted overfeeding as her
caretaking pattern so she doesn't see another way. But even these rare
sumo-babies are pretty evenly distributed between the "at home" and
"working" moms.

Warmly-
Judy Gelman
Washington, DC

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