In a message dated 11/16/2006 2:04:06 P.M. Eastern Standard Time,
[log in to unmask] writes:
* how much breastmilk does an individual baby need to survive and
thrive? We have some figures from the 'world' of formula feeding,
Heather makes a point I have pondered many many times. I cannot express how
nice it is to see another mind considering this reality. Not one single
thing about how much babies "need" to eat and grow for their own "individual"
needs is out there. There are averages, there are comparisons according to
formula, there are the studies done that relate to milk production and volume
and intake. However, there really is no way to know what baby needs an extra
3 or 4 ounces a day to thrive and what baby doesn't. We can't assume
anything because no way do I believe a 2 week old needs 6 ounces, but I have had my
clients telling me their baby drinks that and keeps it in. The bottles come
in 8 ounce amounts, so the assumption is that at some point the baby needs 8
ounces. The concept in bottle feeds and in breastfeeds that are strictly
about 'feeds' are more is better and less often is the goal. This is not a
biological norm, this is a bottle feeding formula feeding cultural norm.
Remember way back with my last baby and my study of one, she was consuming
less than 2 ounces at a feeding even at 8 weeks, and she was over 11 lbs at
birth...and she was having more than enough diapers, content as can be as long
as I did not try to force feed her more because I could not believe that was
enough to live on! Well, at 4 months old she was still averaging only 3
ounces at a feeding, ditto at 6 months. And, well, here we are at a year and she
is still nursing plenty and eats a bit, but my supply is not diminishing
because she still nurses more than she is interested in food, though when she is
interested she eats well. She also is still stooling daily, still wetting
plenty. She is not triple her birth weight..heavens be thanked as she would
be a 36 lb one year old and that would kill my back. She is walking and
running and has been since 8 months old. But, she does not take 6 ounces of milk
at a feeding. Maybe she does not need it. Maybe other babies do not
either.Maybe we are clueless about what babies really need when it comes to
breastmilk amounts because it varies so much feeding to feeding--and that includes
fat content.
I do test weighs. I like to see how all babies are doing. Say a baby is
gaining an ounce a day and happy, I personally just like to see how much milk
the baby is taking in that feeding, and guess what, it is often only 2 or 3
ounces. The babies I have see taking 4 ounces or so are also miserable gassy
colicy kids so maybe they are eating too much too fast. Who knows. The deal
is, the scale is a tool and I like it. But, I am not so sure we are on target
about how much a baby really needs to grow and at what point slow growth and
exclusive breastfeeding is not adequate and the risk of using formula
becomes a benefit.
How can scales help? I have a client I will be working with who has a very
slow weight gaining baby. Scary slow, not just a little slow. They are
considering tests that are invasive. We will use a scale for 24 hrs. to be sure
this is not just a supply issue. The hope is that the baby is indeed not
consuming enough calories because more food we can fix and it will mean no need for
invasive tests. So, yes, I can see the value of a scale. I do think we
need to know more and be sure that the supplements are really needed and risk
benefit ratio is respected with the understanding that as a wise man said
"nutrition is the least of what breastmilk is". (If you did not have the
opportunity to hear Dr. E. Stephen Buescher - The Anti-Inflammatory Characteristics
of Human Milk, take the time to listen by going to the link and scrolling to
the title.
<_http://www.llli.org/podcasts.html?m=0,0,8_
(http://www.llli.org/podcasts.html?m=0,0,8) > )
Take care,
Pam MazzellaDiBosco, IBCLC, RLC
Private Practice LC in Florida, USA
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