I haven't said much about the growth issue.  It's been a stimulating discussion, however, and it has provoked my thinking about the issue of "potential".  If we re-phrased the discussion and were talking about intelligence, I don't think that there would be much argument that it would be wrong to compromise the potential for each child to reach his or her optimal intelligence. I wonder if making value judgements about growth shouldn't factor in the issue of potential.

 As various groups of people known for small stature become better nourished, particularly in infancy and childhood, they become bigger in size. (Whether this is good for the planet -- i.e. larger beings consuming more goods, etc. is, I suppose, open to debate.)  Certainly factors such as public hygeine (sewage and waste disposal), disease, and freedom from conflict play into life expectancy, but in places where these factors are givens, good nutrition adds to life expectancy. (Please accept that I understand that obesity is actually another form of malnutrition). 

 Pooled data seems to support the idea that breastfed infants grow very well in early infancy if they are feeding normally.  Also, data and observation supports the idea that early, well supported breastfeeding typically results in minimal weight loss postpartum and quick recovery of birth weight, and rather rapid growth for some months.  Growth rate and the growth curves of bfg infants begin to taper somewhere between 4-6 months pp.  To me, the big issue is maximizing the infant's potential to grow excellently on breastmilk up to that point and to then look at the infant's situation to see what is the next best thing to do.  It may be to cont. to exclusively breastfed (particularly in privileged environments and in groups of babies showing tendency toward allergy).  It may be, as Jack and Yael have mentioned, to start solids a bit early because mom is going back to work and wants to avoid formula.  Or, as Kathy Dettwyler points out, because baby lives in an impoverished environment where the addition of another source of nutrition would assist that child in better reaching his or her growth potential.  I'm fairly convinced that there is more than one way to be right on the subject of when to start solids.

Looking at baby animals one is always struck by the visible difference between the robust, glossy, thriving animals and the faltering ones.  The first line of defense is to feed - up the runts, and to take better care of them so they can reach their potential for health and energy.

Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates
http://www.lactnews.com

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