>> PRO-LC, my local affiliate, had an eye-opening presentation in November
2003
> by Diane Spatz, PhD, RNC, who shared the results of her
(as-yet-unpublished)
> study, "Strategies to Improve Breastfeeding Outcomes in Low Birth Weight
> (LBW) Infants with Short Hospital Length of Stay (LOS)."
>
> Her surprising finding: it takes *6 to 8 weeks* for baby to nurse
> effectively enough that all caloric needs are met at breast!  Until then,
> Mom needs to be doing extensive pumping to protect her supply, and needs
to
> be monitoring her baby's improving transfer capabilities with pre- and
> post-feed weighs on an accurate scale.
>

I think this is a very interesting study, but would love to have a control
group of mothers who are doing true "kangaroo care" with their babies.

With my daughter-in-law and several other mothers of premature babies I have
worked with, keeping the baby skin-to-skin as much as possible seemed to
make a huge difference. I find the idea of pre and post-feed weighing is
sometimes a problem - because it gets the mother to think in terms of
concrete "feeds" with a defined beginning and ending, when a more natural
way for babies to feed (which often seems to emerge with the constant
skin-to-skin contact) is more or less continuously. (The baby nurses for
five minutes on one breast, dozes for a while, nurses for three more
minutes, poops, gets diaper changed, naps for five minutes, nurses on the
other breast for six minutes, rests for a while, nurses for two minutes,
sleeps for twenty minutes, nurses for three minutes, and so on and so on -
when does the feeding begin and end? Who knows. And does it matter?) These
mothers generally weighed the baby once a day, and added some pumped milk
supplement over the next few feedings if that weight gain was low.

I don't mean to sound critical of the study in saying this. I think it makes
some important points and clearly improved some outcomes. But there is good
research on the benefits of kangaroo care in not only getting breastfeeding
going well but in helping the baby grow and reducing stress for both mother
and baby.

Teresa Pitman

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