>
>
> I certainly agree that  spotting under-nutrition is important, and
> that fixing it can mean breastfeeding lasts longer. But  I am still
> looking for anything that shows us that 'if a baby fails to gain
> roughly 30g per day from about Day 3 and for the first 3 months of
> life then it is a sign that something is not quite right with the
> breastfeeding, that intake is inadequate for some reason'.


And let me mention again the example that I have used in the past - my 
daughter. She weighed eight pounds at birth (and at her birth her doctor 
commented on her small hands and feet and said "she's going to be tiny" and 
I was surprised because I thought eight pounds was a pretty good weight). 
She gained about 4 ounces a week (which is definitely less than 30 grams a 
day) for the first few months, dropping to even slower weight gains after 
that. She weighed 17 pounds at a year. I had lots of milk (I was also 
nursing her older brother) and she had free access to the breast. While 
small, she never looked thin, and she was always very active (walked at 9 
months). I do not believe she was not getting enough to eat - I believe she 
was getting what she needed.

Today, at 28, she is a size zero. She is petite. She is very healthy, runs 
marathons, and just graduated with her Master's degree, setting a record at 
her school for the length of time from beginning the program to graduation.

What we do not have is evidence that a baby who is gaining, say, 4 ounces a 
week but having free access to the breast and is otherwise healthy and happy 
would be better off if given supplementary feedings.

Teresa Pitman

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