On Mon, 23 May 2005 08:45:58 -0400, Teresa Pitman
<[log in to unmask]> wrote:

>I just have a comment/question about some of the commonly-heard guidelines
>or standards for breastfeeding. Why do we say things like "weight gain
>should be 4 to 8 ounces a week?" What if the baby gains 8.5 ounces or 9
>ounces or 12 ounces in a week?
<snip>>
>Another example - the statement that breastfed babies should nurse 8 to 12
>times in 24 hours. I recently had a call from a mother whose doctor told
her
>she had to supplement because her baby nursed 14 times in 24 hours and that
>meant she didn't have enough milk.
<snip> So why don't we make this guideline say "at least 8 times a day?"
>
>Having these ranges suggests an  upper limit when I don't believe the
>evidence supports that upper limit. Anyone else have thoughts on this?
>
>Teresa Pitman
>

Hi Teresa,

I agree, lots of mothers hear "8-12 times a day" and conclude that they
should not nurse more than 12 times a day.  When teaching mothers in the
early postpartum period, I do tell them that they need to nurse *at least*
(I put a verbal emphasis on the "at least") 8-12 times a day with 8 being
the bare minimum.  I encourage them to nurse more often if the baby shows
an interest.  I describe growth spurts and how to respond to them (much
more than 8-12x/day).

I also agree about the weight gain issue.  If a baby is gaining within the
range there is no need to worry about intake.  It doesn't necessarily
follow that gaining more than the range is a problem.  After all, someone
has to be at the top of the growth charts, and there are bound to be some
individuals who are off the charts (I wonder what the mother of Andre the
Giant was told when he was an infant :-)!).

It sounds like a case of confusing "average" or "usual" with "normal", and
then confusing "normal" with "ideal".  Depending on what you're measuring,
being above (or below) the average may not be "ideal" but may be normal and
acceptable for that individual.

-Claire Bloodgood, IBCLC

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