Hello all-
OK-where do I start? First off, it is good to be back. I was no mail for way too long. 

I have some concerns about James O Quinn's post regarding the importance of breastfeeding frequently. Although I don't negate the importance of feeding frequently and we don't want mothers "sitting at the cusp of lactation", I don't necessarily agree with his view that mothers do not have optimal breastfeeding practices if the baby is sleeping long stretches at night. Of course we do not want newborns sleeping for hours on end, but once you have a thriving baby who is gaining weight steadily, then it is appropriate to let the baby sleep as long as they are the ones setting the schedule. I don't agree that the women who do this do not have "optimal breastfeeding practices". Does everyone need to "maximize milk production"? No-as evidenced by women who struggle with oversupply. Of course there are times we need to maximize milk production-as in the baby who is not gaining steadily, or baby is not transferring milk well at the breast. But giving the impression to mothers that they are not cue-based feeding if their baby is sleeping for long stretches is wrong. Every baby/mother dyad is different. I'm not talking about outliers-I see plenty of babies thriving on exclusive breast milk who are not feeding Q3 hrs around the clock. Saying that a mother who allows her baby to sleep a long stretch "only thinks her supply is good but in fact it is not" is simply not true for the majority of women. Yes, I agree that there are some mother/baby dyads who must nurse Q2-3 hrs around the clock to maintain an adequate supply, but I personally feel it is more the exception than the rule. Saying a mom is not breastfeeding well if a baby is not gaining well over seven ounces/week and doesn't double his birth weight by 4 months is not appropriate. It is perfectly acceptable for an infant to gain 5 oz/week and double their birth weight by 6 months-it is not a sign that the mother is not cue-based feeding. All infants follow their own individualized growth curve. Impyling that breastfeeding mothers who allow their infants to sleep for a stretch at night will need to start solids early or "If she  managed to hold off  on solids until the baby was six months the baby ate a lot of solid  food when it finally was offered to him because she in fact had an undersupply and the poor kid  was hungry" is again simply not true! 
Why I am so concerned about his message is that there are women who would be discouraged and think that a breastfeeding lifestyle is too hard and quit early if told they cannot allow their babies to sleep once they are gaining steadily. And if a baby is not latching and you have a mother who is at the end of her rope and you tell her she HAS to pump Q3 hrs around the clock, you are asking her to possibly do something she just can't physically or mentally do at that point time. Let's instead encourage her to pump frequently during the day so she gets those 10 pump sessions in/24 hr period, but let her get a little rest at night. And for the baby who is at the breast, if they are gaining steadily at an appropriate rate, let us listen to the baby and allow them to say how often they need to nurse, and not say that a mom is not cue-based feeding or feeding optimally if they allow their baby to sleep at night.

(For the record, my first child (gasp) began sleeping 5-6 hrs/night at 3 weeks of age, 8-9 hrs/night at 3 months and 10-11 hrs/night at 4 months. When she was 3 months old, I WAS WAKING HER, as I was the one who needed her to nurse. She was exclusively breastfed until 6 months of age, and ate few solids until after 1 year of age. Was she small? Of course-she wasn't 9 lb to begin with. But did she stay on her curve and gain appropriately for her size? Yes. Her weight was 20% at 11 days of age, 20% at 6 months, and 10% at 18 months. My son was no different with regards to how he ate and slept-but his weight sure was different. He was sleeping 6-7 hrs at 10 weeks of age and 9-11 hours/night at 4 months of age. His weight at 2 weeks was 60%, and 50% at 6 months. He did not start solids regularly until 8 months of age (we tried at 6 months, but not interested). 

Of course I don't think my children are the norm with how long their stretches were, but I use them as an illustration-they still were thriving on breast milk only and weren't "starving" and scarfing down solids as soon as solids were offered.
 
Sorry such a long post-must be making up lost time!

Best Regards-
Stacy D. Kucharczk MSN, RN, CPNP, IBCLC
BestFeeding Lactation Services, LLC
Virginia Beach, Virginia
 

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