Dear all:

About the only place I can think of that has high enough breastfeeding rates to do a study 
on normally feeding infants would be in Norway ---- but it would have  to be among 
women wo delivered normally.  Here in the United States there are but a few small 
pockets of women who deliver normally.  Anyone who even enters the hospital even if 
they delivered unexpectedly in the bathroom or the taxi cab will get pitocin.  I think what 
everyone ignores in focusing on the medicines that are used during delivery is that mere 
fact of being in the hospital is disruptive to mother and baby.  Someone once mentioned 
to me and I do not have the reference, that there are something like 85 interuptions per 
day for mothers and babies that are in the hospital.  Even if the interuptions are a small 
fraction of that number, you cannot claim that the interuptions are not disrupting the 
normal cue-led feeding process.  I personally believe that the disruptions to mother and 
baby affect a far larger number of mothers and babies than any medications that are 
used.

So,  it would not be possible to get a large enough sample size at least in Manhattan.  
Then post delivery you must factor in that even if a woman has a normal delivery she 
may not be feeding on cue.  This too, will impact on how an infant feeds.  

I think the only time you would see feeding problems in a normal delivery with a normal 
postpartum on cue feeding process would be if there was something significantly wrong 
with the mother's milk supply or the infants abilty to feed.

The use of a scale for such purposes would be a high cost/low return situation.

I think scales are far more useful in those parts of the world where we are dealing with 
high intervention birthing and abnormal cultural feeding practices.  It is in these 
circumstances that they can be a useful tool to help return the dyad to a more normal 
infant feeding process.

Sooooo, for a study - you would need to be very specific about the population you would 
evaluating.  The results WOULD be different in different settings because of differences in  
delivery practices and cultural beliefs about infant feeding practices.  Given what has 
happened in many developing countries with the rapid decline of exclusive breastfeeding, 
especially in West Africa, I think it would be hard to find a "Normally" fed population.

Best, Susan

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