My only issue with not telling moms to wake their sleeping babies to feed is
the reality that in the US they are most likely sleeping in a separate
room...on the opposite side of the house! and a monitor is needed to listen
for "cues".  So, it is a real possibility that the baby wakes, cues to eat,
finds no one, is an "easy baby" who just doses back off with a missed
feeding.  I wonder how many babies are trying to cue but just not loud enough
for a monitor to wake up a mom.  How about the babies that simply stir and
mom feels them and nurses.  Now, if the baby is right next to
mom...co-sleeping, preferrably skin to skin, than I will trust that the baby
is able to cue and mother is able to pick up on it and respond.  But in this
detached reality telling a mom she does not need to wake her baby to feed
him, could mean to her oh well, a sleeping baby is a happy baby and that may
or may not be true.  I don't know that 3 hours is the magic number, but if we
are saying that breastmilk is digested in under two hours...then by three
hours that baby is probably hungry even if the cue was missed.  Maybe we can
find a balance between the never wake a sleeping baby and wake on schedule,
as well be sure mom can recognize the cues across the house.  As for using
"adaquate weight gain" as a measure...well, maybe it is adaquate, but for
that baby it would be more than adaquate if mom was aware he stirred to eat
two or three times before he awoke with a cry that she heard.

I also agree that breastfeed as needed means when mom needs it too. Haha.
Sometimes I might say, if your breast feel full, nurse if your baby is
willing.  Since leaving the breast full has more supply issues than stirring
a sleeping baby would have, I prefer wake the baby.  I guess I could say
"express" but in my mind baby is better.

Just another opinion...
Pam Mazzella DiBosco  IBCLC  FL,USA

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