To Elizabeth Puzar, Margery Wilson, and others-

Before we can give "ideals" or even "red flags," we need to know and
understand thoroughly what the norms are for unmedicated, early-to-breast
babies who have unlimited access to the breast in the first five days of
life.  I haven't found definitive research on this anywhere. Has anyone else?


Colostrum is a low-volume feed, almost gel-like in consistency. There's
probably a really good reason for babies to take only this stuff until
lactose synthesis kicks in at around 30-hours post birth with a rise in fluid
volume and more lactose in the milk (Hartmann). Until we know why nature
designed it that way (Thanks, MOM), we would be unwise to fool with it unless
the baby is in serious danger, and even then with great caution.

I have my own numbers based more on stooling than urine because I've seen too
many hydrated, starving babies.  The milk transfer is the key, and the
appearance of mom's nipple immediately after BF is a big clue.  Creased = a
problem. Wet, no change in shape = probably OK.

Linda Smith, BSE, FACCE, IBCLC
Private Practice, Dayton OH in the middle of a blizzard right now.