Actually, "growing better" while it does refer to better brains, health,
skin, etc, also DOES refer to growing heavier.
Neifert,M: Clinical Aspects of Lactation, Clinics in Perinatology,
1999;26(2):291. "Pooled growth data from several countries now confirm that
breastfed infants grow as well or more rapidly during the first 2 months of
life, and less rapidly from 3 to 12 months, than current reference
standards." "Reference" in her context refers to formula fed infants. Her
footnote for this remark is: Dewey,K. et al: Growth of breastfed infants
deviates from current reference data: A pooled analysis of US, Canadian,
and European Data Sets, Pediatrics, 1995.
An interesting little article written by two doctors from Zaire, Avoa,A and
Fischer,P: The Influence of Perinatal Instruction about Breastfeeding on
Neonatal Weight Loss, Pediatrics, 1990, 86(2) 312-15. The intervention they
studied applied to good management of postpartum lactation and strong
pre-natal education of the mothers. Their infants lost an average of 3.8%
of their birth weight before beginning to gain. Mothers who did not receive
special instruction had infants who lost 6.5% of birth weight before
beginning to gain. The average weight loss of breastfed babies in North
America at the time of this study was 6.9% (ref. cited for this figure in
Avoa's footnotes was: Frank: Commercial discharge packs and
breast-feeding counseling: Effects on infant feeding practices in a
randomized trial, Peds 1987l 80:845-54). The Avoa article makes this point:
"Although some basic weight loss must be due to necessary neonatal fluid
losses and shifts, it seems that superimposed feeding prctices play a major
role in determining the extent of neonatal weight loss."
I agree. When looking at the low weight loss of most healthy home birthed
babies, or in institutions/settings with good lactation support and mothers
who know what to expect, I suspect that we have plenty of evidence that
normal looks like not too much weight loss and a quick recovery to a growth
pattern that averages about an oz/day or better. I predict that allowing
dyads with known, identifiable risk factors for poor feeding to go home with
babies essentially NPO and to remain that way for weeks will someday be
viewed as being so stupidly careless on the part of the health care system
as to represent ritual starvation.
I accept that I can't fix everything. There are days when I'm doing good to
fix ANYTHING, but I do have an ethical committment to "Base [my] practice on
scientific principles, current research, and information," and to "Take
responsibility and accept accountability for personal competence in
practice." (From the IBLCE Code of Ethics.)
I guess my point is that breastfeeding works well -- most of the time.
When it doesn't, it is a symptom of something amiss. Dysfuctional feeding is
promptly recognized as a crisis in the elderly, or even in animals, but it
is frequently ignored in infants. I don't understand this.
Barbara Wilson-Clay BSEd, IBCLC
Austin Lactation Associates
http://www.lactnews.com
***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html
|
