I just gave a talk at one of our Community Health Centers - actually, it
was divided into 2 sessions with a two weeks in-between.

When I arrived to give the second session I got "challenged" by the
Nutritionist.  She showed me a newspaper article which stated that babies
need to start early drinking water to establish a healthy lifelong habit of
drinking water.  She stated she had talked to all the other nutritionists
she knew in the Eastern Area of Puerto Rico (none IBCLC's) and they all
agreed that my recommendation of exclusive breastfeeding was not correct
for our population and our tropical climate.

Of course I did not have the studies with me, but I mentioned the fact
that:
- Babies who get bottles of ANY liquid which is not breastmilk early on,
can experience nipple confusion.
- When baby is full of water, he/she may not feed as the cue to being
hungry is being fooled by a full stomach.
- As we use the "6 wet diapers" as a measure for the parents to know when
to call - that this may cause babies to not get early attention in case mom
is not making enough milk or baby is not extracting it correctly.
- Our population tends to want to put a lot of things into bottles - and if
they learn that water is OK, they tend to go to the "teas" and juices and
other non-nourishing fluids (like Coke) that we often see them with in the
grocery stores.
- Breastmilk is adequate for fluid replacement even in places such as
deserts, where babies can even have greater risk than in our humid tropical
climate to get dehydrated.

I also recommended that she call the head of the Breastfeeding program at
WIC - a Nutritionist and an IBCLC.
_____

My request - I have made a search in the archives, but did not get studies
related to this problem in particular (we discussed the hypernatremia
caused by incorrectly mixing formula or watering down breast milk).

Does anyone have access to the studies I need?  I would like to mail a few
to her and the person who made the arrangements for me to speak there so
that the staff (which has heard from her how I am totally WRONG on this
point) can have other viewpoints?



Jeanette Panchula, BSW, RN, IBCLC, LLLL
[log in to unmask]
Project Director - Proyecto Lacta - Puerto Rico
http://netdial.caribe.net/~prlacta/
Lactancia Materna '98 - La Mejor Inversion