>Dear Friends:
>     I have worked with several dieticians and  nutritionists that put their
>focus on maternal intake and nutrition as a cause  of baby's poor weight gain.
>     Interns can know that human milk is sufficient,  regardless of mothers'
>diets, and that babies need to eat on cue, for as long as  they need to gain
>weight.
>     warmly,
>
>Nikki Lee


This is also sometimes the case in the UK  - the training here sounds 
as if it may be similar.

Here, babies with faltering growth might be referred by their family 
doctor to a paediatrician, who might then refer in his/her turn to 
the dietitican. We find it can be a matter of luck if the dietician 
is happy with any  breastfeeding after x months (often they are of 
the 'breastmilk turns to water after 6 months' school of 
thought.....I often wonder how that one works!). I have been involved 
with two (separate cases) babies in the past couple of months where 
each dietitian has recommended ceasing breastfeeding completely with 
a young baby, because of faltering growth, and in the most recent 
case, when the mother refused to stop, the dietitian put the *mother* 
on a lactose-free diet to 'prevent' lactose appearing in the 
breastmilk (there had not even been a good diagnosis of LI in the 
baby,  but even if there had been, of course, changing the mother's 
diet would not have made any difference).   That is sheer ignorance, 
and a quick check of the textbook would have corrected that one.

Occasionally, dietitians turn up in the multi-disciplinary training I 
do, and my (limited) experience is they are  not very open to 
updating.....they especially don't care for 'waiting' until  6 months 
to introduce other foods.

I stress I am not 'dietitian bashing'. I have also come across a few 
excellent bf-friendly dietitians, but if there is an issue with 
training and updating, I want to be able to say so :)

Heather Welford Neil
NCT bfc, tutor UK

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