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Subject:
From:
Barbara Wilson-Clay <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 20 Aug 2000 07:30:58 -0500
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To add to Marsha Walker's very helpful post, I can share another couple of
references.

Neville,M. et al:  Studies in human lactation:  milk volumes in lactating
women during the onset of lactation and full lactation.  Am J Clin Nutr
1988, 48:1375-86.  While more about intake than capacity, the authors do
state:  "Milk transfer to the infant was low on days 1 and 2 and increased
rapidly to 498+-129 g/d on Day 5..."

The next reference speaks more directly to capacity.  It reported on a group
of 60 normal Chinese newborns born at term with good Apgars.  Group A
newborns were breastfed on demand without supplements.  Group B newborns
received mixed feeds, breastfeeding 4 times daily and receiving 6 formula
feeds/day.

Wang,Y et al:  Preliminary Study on the Blood Glucose Level in the
Exclusively Breastfed Newborn, J Trop Peds 1994, 40:187-88.

"The amount of breastmilk secreted by the mother is suitable for the
variation in the capacity of the stomach of the newborns day by day.  The
capacity of newborn stomach after birth is very small in the first 2 days.
In a 3 kg baby, for example, the average physiological capacity of the
stomach is 6 ml on the first day and 12 ml on the second day after birth,
while the average mother's colostrum is 25-56 ml on the first day and
113-185 on the second day."  The authors note further:  "By the sixth day
after birth, the weight increment in Group A is even higher than the
newborns in the control group.  Basing on the rate of increment, the average
time required to regain their birth weight is 9.36 days in Group A, slightly
less than 9.44 days in the control group."

This study seems to bear out my own clinical observations that normal,
well-feeding breastfed infants do fine on just colostrum, grow as well or
better than reference babies (i.e. artificially fed infants), and early
growth faltering is a red flag for poor feeding.  When we identify an infant
who struggles to re-gain birth weight by day 10, we can begin gentle
interventions to protect the baby, the milk supply, and the potential to
breastfeed.  We need to remember other research that suggests that mothers
who accurately perceive that their infant is hungry will begin to
compensate.  We need to be available to make sure the compensations preserve
a normal outcome, which is defined as full and exclusive breastfeeding with
excellent infant growth.


Barbara Wilson-Clay BSEd, IBCLC
Austin Lactation Associates
http://www.lactnews.com

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