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Lactation Information and Discussion

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Subject:
From:
Kathy Eng <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Fri, 17 Nov 2006 17:21:04 -0600
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The concern on how much to feed a baby is only when the breastfeeding is 
not going well. When baby is nursing well and gaining weight just at the 
breast, nobody cares. But when we have a baby with poor weight gain or 
huge weight loss, mothers do need guidelines on how often and how much 
to feed, diaper counts, etc. I use the information in The Breastfeeding 
Answer Book, 2 to 2.5 ounces of formula or breast milk times the baby's 
weight (or what the weight should be). I believe this textbook also says 
normal amounts seem to be 28-32 ounces a day for the older babies, not 
the 40-60 ounces of formula many bottle feeding moms we see at WIC are 
giving. With those skinny, starving babies, I mostly go to 2.5 ounces 
per pound and estimate from what the weight should be not what it is today.

This estimation can be very helpful in diagnosing what might be wrong 
and why baby isn't gaining after you do a test weight. I use it to 
explain to moms when they are feeding a small baby 2-3 ounces after 
every nursing. I also use this formulation when working mothers call and 
say they can not pump enough and baby is eating 20 ounces at daycare. I 
talk to them about normal intake amounts and what their baby really 
needs calorie wise so they can cut down on the bottle amounts at 
daycare. The other aspect is that if test weights show excellent intake 
and are the same or more than this formulation BUT baby is not gaining 
weight, we might need to have the pediatrician look at health issues in 
the baby.

LCs need to know how much to recommend that a mother feed her baby when 
things are not going well at the breast only. And of course, it is only 
an estimate but LCs have to have something to guide mothers in the care 
plan.

Kathy Eng, IBCLC Houston, TX

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