>I have noticed many of the babies in my practice start to have problems
>gaining weight at four months.  I think it may have to do with 2
>factors:
>
>1.  Many mothers start to go back to work after 3 months.
>2.  The mothers become lax after a few months taking care of themselves.
>    They start running around too much, don't rest as much as they
>    should, don't spend as much nursing time with the baby...

Susan,
How often do these mothers routinely breastfeed?  I've seen this problem
all too often among mothers who schedule feed and/or feed their babies
less than normally demand-fed babies-- classically around 4 mos.  There
is a study that was done tracking mothers who breastfed less than 8 times
a day, and those feeding 8 or more times a day. The former group had a
high rate of weaning and supplementation at the 3-4 mos mark, while the
latter group had a high rate of breastfeeding still going strong.  This
seems to correlate with deCarvalho's theory on the development of
prolactin receptors during the first 3 mos postpartum being dependent
upon frequency of feeds.  Yes, we can pump up some of their supplies with
galactogogues, but not always.

Lisa Marasco, BA, IBCLC