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Subject:
From:
Kathy Eng <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 20 Nov 2005 15:42:48 -0600
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Has anyone said this yet? I often tell moms whose daycare is bottle feeding 
too much to tell the caregiver "the pediatrician or doctor said the baby 
needs only __ ounces per feeding and only ____ bottles per day." Reflux or 
colic are good reasons to give. Have the caregiver sit the baby upright with 
the bottle horizontal to the mouth to slow the flow and stop and burp every 
ounce to make it a slow feeding. The bottle nipple should not be filled with 
fluid, rather about half full (don't worry about too much air, worry about 
too much flow). If an older baby nurses 10 minutes on each side but the 
bottle feeding takes only 5 minutes, one can see how some babies might be 
unhappy at the lack of comfort sucking.

I explain to moms that about the recipe for feedings that is in the 
Breastfeeding Answer Book (2 to 2.5 ounces of human milk or formula times 
the baby's weight in 24 hours). If she says her baby is about 10 pounds then 
I explain this baby needs approximately 20-25 ounces a day so if they are 
feeding 4-5 bottles of 4 ounces while at daycare, she can see that this is a 
baby who may not nurse well at home, plus mom starts to lose her milk 
supply.

For small babies, I encourage mom to have the caregiver feed about 12 ounces 
a day (total) broken down into 4-5 feedings (12 ounces divided by 4 or 5). I 
base my suggestion on how a breastfed baby takes in 28-32 ounces a day at 
the breast. My suggestion is to feed less at daycare and more at home 
(reverse cycle feedings). She needs to nurse once or hopefully twice before 
work, immediately after work, and several times in the evening and once more 
in the night. I suggest at least 8 feedings/pumpings in 24 hours with 3 at 
the pump and 5 or more at the breast when mom and baby are together. Some 
women can fudge this a bit but for alot of women doing less creates a low 
milk supply.

Also the research out of Australia by Hartman's team showed how the babies 
took their largest feeds in the middle of the night! So keep up those night 
feedings!

Kathy Eng, BSW, IBCLC 

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