Jan et al,
Jan, Thanks for sharing the story of the baby with "adequate" stooling, but
not enough milk transfer and no weight gain. I have enjoyed the discussion
that has followed. It will help make our assessment parameters in the
future more precise.

I think that the problem is that we are looking for "one" number to make
our judgments. It reminded me of the statement that drives me crazy: "You
don't need
to nurse any longer than 10 minutes because the breasts are"empty".(We
won't even go into the "empy" thing!) Or, you must nurse 10 minutes to get
"all" the milk. Years ago I wondered where this "10 mintes" came from---It
seemed that it came from studes that looked at frequency and duration.
Howie, et al,
1981, Early Human Development, 5:71-77 found that the mean duration of a
feed was 17.3 minutes(per feeding). de Carvalho, et al. 1982, Early Human
Development, 7:155-163 found the mean to be 16.8 minutes. I assumed that
people just adjusted up a bit to get to the 10 minute recommendation. But,
the mean is a mathematical construct. No person is a "mean". People "live"
in the ranges. What was interesting in the studies was the broad range of
both feeding durations and frequencies. The range of feedings in the
deCarvalho study was 9.5 min-40.6 min (1st 14 days) and 9-43 min (at 1
month).

I think it is better to use ranges in looking at what is "normal".
Regarding Jan's Mom, is it possible that there is a large range of normal
stooling. I think Jan said that the baby had 4 stools a day?? Perhaps, for
this baby when she? had adequate intake she would have had 8 stools a day
or one with each feeding. Does this make sense??
And then none of this is the perfect answer. Babies need to have follow up
and be seen.