Dear all:

Now its not just me, I'm hearing increasing complaints from IBCLCs in NYCity.  They are becoming frustrated with practitioners (and unfortunately some IBCLCs themselves) that they have low supply when these practitioners have ONLY assessed weight loss or gain, not the mother's capacity to make sufficient milk or even how much she can pump.  These mothers are often devastated and need quite a bit of confidence building that they really can make enough milk. Alternatively these mothers become angry when they figure out for themselves that expressing milk (via hand or pump) that they really do have the milk.  Why oh why would one conclude that just because the baby lost weight, the mother doesn't have enough milk?  Yes, sometimes after prolonged underfeeding, the supply will drop, but that really requires ASSESSMENT, not ASSUMPTION.

I do not understand why practitioners cannot grasp the concept that a baby may not always be driving the supply adequately and therefore, you really must investigate why that baby isn't driving supply.  Here in NY City despite the ban on bags, other hospital procedures often interfere with adequate contact between mother and baby leading to loss of feeding opportunities and excessive weight loss or slow weight gain.  While I applaud "banning the monopolistic distribution of promotional samples of formula", it will never be sufficient to stem the tide of generations of baby unfriendly practices.  Until such time as we resuscitate baby friendly practices not just in the hospital, but also in pediatric practices, health care practitioners must be able to assess the difference between a baby drive drop in demand and a mother driven drop in supply.   

Susan E. Burger, MHS, PhD, IBCLC

PS.   I think we need to change the terms "Ban the Bag".  This has given civil libertarians a rallying cry.  We actually are increasing choice by removing a monopoly.

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