Pamela, you really got to me with this: "One of the paradoxes of
low-weight-gain or FTT babies I've noticed is that the thinner the baby the
*stronger* he is, the little muscles like
iron, little hands scrabblng and clawing to grip on *anything*."

I'm sure that we all here know *exactly* what you mean - and don't forget
that "worried", alert look - it's something with the eyebrows, above the
nose, can't exactly describe it but we know it when we see it.

The thing that gets me is how very often mothers (and others in the family)
don't recognize these as troublesome signs - how often they think of that
strong, clawing, high-tension look is "proof" that the baby is "so strong".
"I can't even put him down - he just grabs onto me and clings like a baby
possum", they say, and I'm thinking "well, yeah, he's hungry and he's
smart - of course he doesn't want to be plopped down and separated from his
only possible source of satisfaction!"

Kind of similar, only in the opposite direction, to the universally-dreaded
"good baby", the poor little lethargic ones that are too weak to cry or
raise a ruckus or scrabble around frantically. The ones that "never make a
peep" as they waste away.

I've learned to absolutely trust my instincts on these babies. I also now
carry around a lot of photographs of babies in various states, including
that perfect milk-face, and use the pictures when I'm talking with parents,
so they can *see* what I mean when I talk about how the baby's hands should
be loose and opened, and *see* how the whole posture opens up and relaxes,
when he's had enough.

I guess it's naive to expect that parents will just recognize
"instinctively" when the baby is satisfied. Or, more complex, when the baby
*hasn't* had enough, but has just given up trying for the moment. I didn't
know it with my own first baby - figured if he looked like he was asleep
when I took him off, he must have had enough, and ought to be content for a
couple more hours.

Cathy Bargar, RN, IBCLC Ithaca NY

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