Kathy asked about how to politely refute the misinformation she expects to
be given by a nursery nurse regarding the need for supplementing newborns
before the milk comes in. I think it is a great idea to use Marsha Walker's
"Just One Bottle" handout. In addition, you might want to use the
information Marsha wrote in a Lactnet post on August 19, 2000, entitled,
"Stomach Capacity of the Newborn." When I read Marsha's original post, I
wrote to ask her permission to share it with moms in my breastfeeding
support groups. Since she gave me permission to share with them, I am sure
she won't mind if I "reprint" it here:
*********Begin quote**************
Date: Sat, 19 Aug 2000 14:32:19 EDT
From: [log in to unmask]
Subject: Stomach Capacity of the Newborn
Beth has referred to my lecture at ILCA on supplementation and the stomach
capacity of the newborn. I use this as an illustration of the amount of milk
that a newborn can consume. I quote these numbers to parents and providers
who continue to try and stuff unreasonable amounts of food into little
babies. The stomach has both a physiologic capacity (the amount held
comfortably after a meal) and an anatomic capacity (the amount that you can
put in on Thanksgiving). These two amounts are different. The physiologic
stomach capacity of a newborn between 2-4kg on day one is 7ml per feeding as
in the amount of colostrum mother is producing (not 3 ounces like in the
bottles of formula).
Beth asked about the anatomic capacity of the stomach. For a newborn between
2-4kg in weight the anatomic capacity is 30-35ml. A one week old infant of
all weights is about 45ml and a two week old infant is about 75ml. I have
used these numbers for many, many years to illustrate to parents and
providers with a dropper or syringe what 7ml looks like. It does not look
like 3-4 ounces!
Now you say, WHERE ARE THE REFERENCES!!! There are very few current
references on something as simple and elementary as this. One of the
references is actually older than I am which makes it an antique but still
worth listening to.
Scammon RE, Doyle LO. Observations on the capacity of the stomach in the
first ten days of postnatal life. Am J Dis Child 1920; 20:516-538.
I am always amazed at the lack of understanding we have about the normal
newborn anatomy and physiology. If we just looked at things like this we
would see how outrageous it is to try and mimic bottle feeding with a
breastfed baby. Health care providers show the same lack of knowledge about
other things like newborn glucose metabolism, which explains the downright
bizarre hypoglycemia protocols I see floating around the country. We let
babies cry to exercise their lungs! When did the lungs become muscles?
Crying directly contributes to the low blood sugars we see so often as the
glycogen stores get depleted at the speed of light while we worry about
spoiling the baby!
I think we need a conference on what is normal!!
Marsha Walker, RN, IBCLC
**********end quote*************
Good luck on Wednesday, Kathy!
Sara Furr
LLL Leader
Lincoln, Nebraska
(who also has to say that I would not assume, as some seem to be doing, that
all the residents will be male...after all, Dr. Leeper is a female!)
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