Regarding the BMJ article on effects of volunteer breastfeeding support,
suggested by Heather:

http://bmj.com/cgi/content/full/328/7430/0-d?etoc

Among the interesting responses, was a response by the primary author of
the study, which said:

<We had realized that poor weight gain in breastfed babies in our
practice was related to poor feeding patterns e.g. prolonged feeds, often
using only one breast at a feed, and an irregular feeding pattern. The
weight gain improved enormously when these patterns were improved. A
regular stable pattern (approximately 3 hourly during the day, often
longer gaps at night) using both breasts at each feed, approximately 10
minutes each side, much improved weight gain. We now see babies who gain
up to 1lb (and sometimes more than this) a week in the early weeks. >

As a volunteer counselor for WIC, proactively calling new breastfeeding
mothers only some of whom report the birth of their babies to us, as
requested by WIC, I often find mothers who either don't remember or
haven't been taught in the hospital some of what I now consider to be, in
our society, basic breastmilk stimulation information, such as breast
compression if the baby falls asleep easily at breast, the existence of
the let-down reflex, fingertip expression to soften the areola, and the
general principle of "Let baby soften the first breast first before
deciding to offer the second."

It is both a heartening experience to hear the mothers welcome such
information and a disheartening experience to discover other mothers have
given up breastfeeding for the "ease" of formula because they have
equated not only the product but the process of infant feeding by
extrapolating from their experiences when they were teen babysitters,
etc.

So often, it seems necessary to "reinvent the wheel" with each new
inexperienced mother, and sometimes, with experienced ones too, since
they are often operating on older information. I praise the value of
"helping the baby get to the hindmilk" if necessary.

Jean
************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA

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