Pam and others, I wanted to respond to this topic even though it was  several 
days ago that you posted.  
I have and use the "belly balls" from Ameda.  A picture can be so  powerful 
sometimes verses a verbal description.  What I see fault in the  belly balls is 
that the stomach size or capacity is not what is really at the  root of what 
babies want or need in the first few days; it is about the  physiological 
norm.  
So the nurses and doctors are correct in saying newborns fed bottles can  and 
do take more than 7-10 cc per feeding.  Newborns can take 45-60cc  sometimes 
but watch out because we all know they will be spitting up for hours  after 
this.  This the staff take as "normal" newborn behavior and do not  think much 
about what is happening to this poor new baby!
The basis behind what a newborn needs and wants is far more than stomach  
capacity.  The work from the 1920's paper is the foundation to the average  
intakes of the newborn and authors such as Peter Hartman and others have added  
onto this work.  There have been pre and post weights to show how much a  baby 
consumes at different feedings at different days old.  There has been  
measurements of expressions from moms on each day postpartum and ultrasound  
measurements by Peter Hartman's team.  These all look to volume but there  is another 
piece to this puzzle.  The composition of breast milk.   Colostrum has 3 times 
the protein of mature milk.  The sugars and fats are  lower than mature milk.  
This high protein is what stabilizes the newborn's  insulin without 
overwhelming their poor delicate digestive system in the early  days.  To use Kcal/Kg to 
determine the needs of a newborn to treat  hypoglycemia is just not enough.  
Of the 45cc of formula the newborn chugs,  how much do they retain and use?  
Because formula is an unchanging  composition does it require a large volume to 
treat hypoglycemia in  newborns?  There are studies showing skin to skin 
alone stabilizes blood  sugars for babies.
My understanding of newborn's needs and capacities is based some on the  
literature and some on just basic physiological common sense.  
A newborn is going through the most dramatic change in their life.   This 
adjustment from intro uterine life to extra uterine life could be compared  to: 
either what a woman's body is going through in labor or anyone coming our of  
major surgery.  In both the latter cases the human body is adjusting to  what 
is going on which leading to depressed appetite, slowing of the peristaltic  
wave in the gut, and over all discomforts.  Each person is different on how  
they handle these scenarios and if they listen to their own bodies they will  
know when they can advance in their diets.  Some babies will breastfeeding  often 
and take more in than others.  If truly observing the newborn for  their 
ability and willingness to feed, most take in what they need and remain  stable.  
Because of birth interventions, separation of mother and baby, the  influence 
of the formula industry, and lack of knowledge of many; the quantify  and 
quality of breast milk (including colostrum) is on trial.  
So why do some newborns appear to be hungry and take large volumes of  
formula?  I have brought this up before on emails regarding bottle feeding  so I 
will make this brief.  Almost everyone bottle feeds babies  incorrectly.  The 
nipples are fast flowing, gravity is allowed to be used,  babies want to suck but 
both non nutritive sucking and nutritive sucking which  allows larger volumes 
of formula to be delivered to the poor baby's stomach, and  there are many 
babies that are basically force fed because this can easily be  done with a 
bottle.  
Pam, remember breast milk and breastfeeding is the standard for  babies.  
When others tell you they do not believe this concept of smaller  intakes in 
newborns ask them to bring you the science to their argument. 
Change is hard and takes a long time.  We have to be patient but  continue to 
stay on course and the "belly balls" are helping to get that message  out.
Any comments welcomed.
Ann Perry, RN, IBCLC
Boston, MA



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