>In response to:
>
>Dear Friends:
>    Kent et al. found that mothers make a range of 440-1200 ml of 
>milk in 24 hours. How can we be so precise about how much a baby 
>should take when mothers are so variable, and babies only take 
>around 76% of what is in the breast?
>    warmly,
>
>
>Nikki Lee RN, MS, Mother of 2, IBCLC, CCE, CIMI
>_http://www.breastfeedingalwaysbest.com/_
>For those of us who are not HCP, doctors or nurses able to give 
>medical advice, we use our textbooks and go with the intake 
>guidelines given therein. Now, we have also discussed this topic to 
>death and I am dismayed to see our profession act so ignorant and 
>try to say poor weight gain or intake is okay because whatever 
>opinion  we have.


Kathy,  do you not think Nikki's question was an example,   not of 
being 'ignorant' about the risks of poor weight or intake, but of a 
justifiable interest in  the question of how we *define* poor weight 
or intake, given other aspects of our knowledge?


>  If an IBCLC choses on her own to decide what is okay intake, then 
>let's hope you carry liability insurance. For myself, I am content 
>to use our textbook materials as per what is adequate milk intake 
>and weight gain. Again, when you have a baby not gaining weight, a 
>responsible IBCLC must give guidelines or ask the HCP to give 
>guidelines for what intake should be or needs to be.
>Kathy Eng, BSW, IBCLC


The textbooks are not always 'set in stone', and I feel it's good 
when breastfeeding supporters of whatever hue continue to develop the 
knowledge and practice  base by exploring, discussing and dissecting 
the evidence. I don't think we have discussed this topic to death at 
all!  Heavens, when  I first got into this area, the textbooks said 
some things which we know now are neither helpful nor true.

It's also not fair,  or in the spirit of Lactnet, for that matter, to 
charge fellow posters who show manifest goodwill with 'ignorance' or 
suggest they engage in unsafe practice.

Heather Welford Neil
NCT bfc, tutor, UK

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