>Supplementing
>messes with supply too much over longterm breastfeeding for me not to assist
>mom in stopping the supplements.

I *knew* I didn't explain myself well.  I'm not talking about using
supplements to replace breastfeeding longterm - or to "replace"
breastfeeding at all.  Let's say a baby has lost significant ground on the
charts.  He needs ten units of food for optimal growth, and 7 units for any
sort of growth at all.  His mother is making only 7 to start with.  My first
approach would be not to supplement, but to work with mom to p-u-l-l that
figure up and up until she gets to ten.  That's where you might see a weight
gain of 4 oz the first week, 7 or 8 oz the second, and finally the baby is
actually improving his position on the charts.

But suppose she's making only 6 units to start with  (this is all
theoretical and way too simple, to try to get this across fast).
Supplements are clearly needed.  Or let's say she's making 7 but formula has
already been started.  I can supplement with one unit of formula, and not
have the baby's growth catch up fully until the mom's supply gets to ten.
Or I can supplement with enough units to optimize baby's catch-up growth
("pour it in"), and work on mom's supply at the same time, cutting back
supplements only as the mom's supply is able to replace them and keeping the
baby's intake at ten through the whole experience.

My inclination is to do the second:  if I'm going to break the formula
barrier (or if someone else already broke it), I figure I'm not increasing
the risks even more by using all the baby wants during the period when he
needs it for optimal growth.  Yet I've seen other LCs hold back, limiting
baby's catch-up growth by restricting supplements while they wait for mom's
supply to increase.  I was wondering which approach other LCs do and how
they justify it.

Diane Wiessinger, MS, IBCLC  Ithaca, NY
www.wiessinger.baka.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