LACTNET Archives

Lactation Information and Discussion

LACTNET@COMMUNITY.LSOFT.COM

Options: Use Forum View

Use Monospaced Font
Show Text Part by Default
Show All Mail Headers

Message: [<< First] [< Prev] [Next >] [Last >>]
Topic: [<< First] [< Prev] [Next >] [Last >>]
Author: [<< First] [< Prev] [Next >] [Last >>]

Print Reply
Subject:
From:
Chris Mulford <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 20 Oct 2005 09:58:32 -0400
Content-Type:
text/plain
Parts/Attachments:
text/plain (88 lines)
Responding to 
Date:    Wed, 19 Oct 2005 23:22:43 -0400
From:    PATRICA A Bucknell <[log in to unmask]>
Subject: Nipple Confusion

. . .
Since Peter Hartmann & his team's research has been published, I have
changed what I tell moms about how much breastmilk their baby needs while
separated.  Hartmann et al say that once a BF baby is 3-4 weeks old, they
only need about 24 oz of breastmilk/24 hr to gain and grow through the first
6 months.  I just think it is so amazing how our milk can reconfigure itself
to meet the age of the baby and so the baby doesn't need more ounces to gain
and grow!!  
. . .

             ***********************************************
Hi Pat,
My understanding is a bit different from yours. Maybe I need to update!

The top graph on page 82 of 'Nutrition during Lactation' (originally from an
article by Neville et al that reviewed 16 studies of milk volume from the
1980s) shows that the mean milk intake of exclusively breastfed babies rises
from about 700 to 800 grams per day between 1 month and 6 months. That's
abut 23 to 27 ounces, so it's close to your 'about 24 oz,' but it's an
*average,* so there will be some babies who need more ounces per day as well
as some babies who need fewer. The graph actually shows the mean plus one
standard deviation. The babies one SD below the mean varied from about 550
to 650 grams per day over the same time period. The babies above the mean
varied from 800 to 900 grams per day. So, looking at milk intake by---what
is the mean plus one SD? 90% of the population?-a large majority of the
exclusively bf babies, their daily intake could be anywhere from 550-800 at
1 month to 650-900 at six months. 

I still think '24 ounces a day' is a useful fact-especially since it's easy
to remember and understand. I try to stress it when I talk to moms who are
worried about milk production. I tell them that the average exclusively
breastfeeding mom makes just over an ounce an hour. I intend this to be
reassuring to moms who are able to pump 'only' 1-2 ounces at a sitting. Moms
with bigger babies probably need to work toward pumping a bit more.

You say that the milk changes, 'reconfigures itself to meet the age of the
baby.' That's where I'd love to see your sources. Woolridge reports that
milk increases in caloric content when suckling is more frequent, but I
think this happens because of changes in the suckling pattern/breast
drainage pattern, not because of the baby's age. Lactose is pretty constant
at 7%. Are there significant changes in protein content between 1 and 6
months?

We do know that the baby's gut changes. Klaus and Kennell's forward to
Lawrence and Lawrence tells us that the 19 GI hormones released by both mom
and baby during suckling cause an increase in the number of intestinal
villi, thus giving a greater area of surface to absorb food and making
better use of the nutrients ingested. So it's not just about the milk!
Perhaps it's the growth in the baby's gut that allows the baby to double his
or her birth weight by six months, while the milk supply increases by only
about 12 to 18 percent.

It's all so amazing, and there's still so much to learn.

Cheers,
Chris Mulford, RN, IBCLC
LLL Leader Reserve
working for WIC in New Jersey
Co-coordinator, WABA Women & Work Task Force

Institute of Medicine, Subcommittee on Nutrition during Lactation, Committee
on Nutritional Status during Pregnancy and Lactation (1991) Nutrition during
lactation. National Academy Press, Washington.

Woolridge MW (1995) "Baby-controlled breastfeeding: biocultural
implications. In Stuart-Macadam P & KA Dettwyler, Breastfeeding: biocultural
perspectives.Aldine de Gruyter, New York, pp 217-42.

Woolridge MW and JD Baum (1991). Infant appetite control and the regulation
of breast milk supply. Children's Hospital Quarterly 3:2, 113-119.

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html

ATOM RSS1 RSS2