I agree, dear friends, that total amount of milk *digested* is the main factor in growth. So if mom has lots of milk, however low-fat it may be, baby will grow if he digests all he is getting in. But, when mom has real oversupply issues and baby can not cope with all the lactose (because by lack of fat the gut empties faster and probably not enough lactase is available in that shorter time to digest all of the lactose), the gut contents starts to ferment in the wrong way, causing gas (and with it the typical green, frothy stool) and baby does not take enough nutrients and energy from it and will not grow despite of the huge intake.
This is where, in my as usual not very humble opinion, the stories originate that ''my milk is just water: baby drinks all day, pees a zillion nappies full, but doesn't gain''.
Warmly,
Gonneke, IBCLC in PP, LC lecturer in southern Netherlands
Twitter @eurolacpuntnet
--- On Tue, 6/21/11, Susan Burger <[log in to unmask]> wrote:
From: Susan Burger <[log in to unmask]>
Subject: Re: Oversupply does not cause failure to thrive
To: [log in to unmask]
Date: Tuesday, June 21, 2011, 4:41 PM
In response to Sonya:
Cathy Genna has posted previously some nice studies that debunk this notion. It is not having an overabundance of milk that causes slow growth. All the studies show that when babies take in a greater volume of milk, they grow faster. What can happen, however, is that babies may be able to feed from one breast at a time from a mother with a high supply. This then tamps down the supply because the breast is being drained half as often as it would if she were feeding from both sides. At some point, the supply may drop to the point where the baby may actually need the second breast. Or, what I see very frequently is the mother is told to sleep train her baby. So, she might feed the baby only four or five times per 24 hours, which means each breast is only getting drained two or three times a day. Then the supply collapses. The vast majority of cases of failure to thrive that I see among 3-6 month olds is simply because the baby is not being
fed frequently and the breasts are not being drained frequently enough to sustain the supply. Nancy Morbacher's piece on the Magic Number in Clinical Lactation does a great job of explaining the physiology of this.
Best regards, Susan E. Burger, MHS, PhD, IBCLC
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