In a message dated 11/16/2006 2:04:06 P.M. Eastern Standard Time,  
[log in to unmask] writes:

* how  much breastmilk does an individual baby need to survive and 
thrive? We  have some figures from the 'world' of formula feeding,


Heather makes a point I have pondered many many times.  I cannot  express how 
nice it is to see another mind considering this reality.  Not  one single 
thing about how  much babies "need" to eat and grow for their  own "individual" 
needs is out there.  There are averages, there are  comparisons according to 
formula, there are the studies done that relate to milk  production and volume 
and intake.  However, there really is no way to know  what baby needs an extra 
3 or 4 ounces a day to thrive and what baby  doesn't.  We can't assume 
anything because no way do I believe a 2 week old  needs 6 ounces, but I have had my 
clients telling me their baby drinks that and  keeps it in.  The bottles come 
in 8 ounce amounts, so the assumption is  that at some point the baby needs 8 
ounces.  The concept in bottle feeds  and in breastfeeds that are strictly 
about 'feeds' are more is better and less  often is the goal.  This is not a 
biological norm, this is a bottle feeding  formula feeding cultural norm.  
 
Remember way back with my last baby and my study of one, she was consuming  
less than 2 ounces at a feeding even at 8 weeks, and she was over 11 lbs at  
birth...and she was having more than enough diapers, content as can be as long  
as I did not try to force feed her more because I could not believe that was  
enough to live on!  Well, at 4 months old she was still averaging only 3  
ounces at a feeding, ditto at 6 months.  And, well, here we are at a year  and she 
is still nursing plenty and eats a bit, but my supply is not diminishing  
because she still nurses more than she is interested in food, though when she is  
interested she eats well.  She also is still stooling daily, still wetting  
plenty.  She is not triple  her birth weight..heavens be thanked as  she would 
be a 36 lb one year old and that would kill my back.  She is  walking and 
running and has been since 8 months old.  But, she does not  take 6 ounces of milk 
at a feeding.  Maybe she does not need it.   Maybe other babies do not 
either.Maybe we are clueless about what babies really  need when it comes to 
breastmilk amounts because it varies so much feeding to  feeding--and that includes 
fat content. 
 
I do test weighs. I like to see how all babies are doing.  Say a baby  is 
gaining an ounce a day and happy, I personally just like to see how much milk  
the baby is taking in that feeding, and guess what, it is often only 2 or 3  
ounces.  The babies I have see taking 4 ounces or so are also miserable  gassy 
colicy kids so maybe they are eating too much too fast.  Who  knows.  The deal 
is, the scale is a tool and I like it.  But, I am not  so sure we are on target 
about how much a baby really needs to grow and at what  point slow growth and 
exclusive breastfeeding is not adequate and the risk of  using formula 
becomes a benefit.  
 
How can scales help? I have a client I will be working with who has a  very 
slow weight gaining baby. Scary slow, not just a little slow.  They are 
considering tests that are invasive.  We will use a scale  for 24 hrs. to be sure 
this is not just a supply issue.  The hope is  that the baby is indeed not 
consuming enough calories because more food we can  fix and it will mean no need for 
invasive tests.  So, yes, I can see the  value of a scale.  I do think we 
need to know more and be sure that the  supplements are really needed and risk 
benefit ratio is respected with the  understanding that as a wise man said 
"nutrition is the least of what breastmilk  is".  (If you did not have the 
opportunity to hear Dr. E. Stephen Buescher  - The Anti-Inflammatory Characteristics 
of Human Milk, take the time to listen  by going to the link and scrolling to 
the title.
<_http://www.llli.org/podcasts.html?m=0,0,8_ 
(http://www.llli.org/podcasts.html?m=0,0,8) >   )
 
Take care,
Pam MazzellaDiBosco, IBCLC, RLC
Private Practice LC in Florida, USA

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