Dear all:

I am astounded that any health care practitioner would even ask that question. But no one has asked, WHY did the practitioner ask that question. The response probably should be tailored to the why.  

 The milk volume at six months is in MANY MANY references texts.  A normal healthy newborn drinks between 25 to 35 ounces per 24 hours at 6 months of age.  A normal newborn that is being fed solids prematurely may not be drinking that much, and if they are overstuffed with too many offerings of solids, they often WILL start to fail to thrive because no solid has the nutrient density of breastmilk.  If they are overstuffed with formula, they may become overweight. Nancy Morbacher's book "Breastfeeding Answers Made Simple" is a great resource for references and I was able to look up that six month olds who are formula fed need 9% more calories because of the extra metabolic cost of processing the higher protein levels in formula (p. 207).  On average, formula fed babies drink more than that -- they drink 23% more (p. 206).  So, no wonder they end up weighing more and at higher risk of obesity later.  So, if a practitioner suggests amounts based on a formula fed "reference", they are contributing to the childhood obesity epidemic. 

Yes, we all know that what babies eat varies from feed to feed, but we should all know what the AVERAGE range is so that we can reassure mothers and if necessary help them get back to normal.  I am finding lots of babies drifting down the curves during the 3-6 month window because of regimes that have the baby feeding too infrequently.  These regimes are based on the false references of unhealthy formula feeding practices.

Sincerely, 

Susan E. Burger, MHS, PhD, IBCLC

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