Pamela, now in the UK, writes:
> However, one of my specialties was working with low weight gain or
>failure to thrive babies, and - for me - a baby's weights, from
>birth, always tell a story. If the primary purpose of breastfeeding
>is to feed the baby, and if a baby fails to gain roughly 30g per day
>from about Day 3 and for the first 3 months of life, then it is a
>sign that something is not quite right with the breastfeeding, that
>intake is inadequate for some reason, and the quicker the cause is
>discovered, addressed and remedied, the easier it is to preserve
>breastfeeding.
I certainly agree that spotting under-nutrition is important, and
that fixing it can mean breastfeeding lasts longer. But I am still
looking for anything that shows us that 'if a baby fails to gain
roughly 30g per day from about Day 3 and for the first 3 months of
life then it is a sign that something is not quite right with the
breastfeeding, that intake is inadequate for some reason'.
This seems to me to be very specific, Pamela - even allowing for your
'roughly' - and while a baby gaining this amount is almost certainly
perfectly adequately nourished, is it not possible that a baby may
gain less than this and still be ok - and just physiologically small?
How do we know that this very specific figure is correct for babies
in general? How do the WHO charts for normally-feeding babies
translate into weight gain per day/week/month? Has anyone done the
maths on this?
I am not being provocative, truly - I just don't know how we know
enough about normal, healthy weight gain in excl bf babies *across
the spectrum* to be able to have something as definite as this, so
definite that you say a baby failing to fit this pattern is, per se,
not adequately nourished.
It's also not what mothers are routinely told in the UK - not that I
am saying what mothers are routinely told has got to be correct! But
if you do practise here, you may find yourself in conflict with
mothers' other sources of info on this specific point. I don't think
what mothers are sometimes told here - that a weight gain needs to be
something averaging out at between 4-8 ounces a week, sometimes
(inaccurately) translated as 100g -250 g - is soundly
evidence-based....but they are definitely not looking for 30g a day.
And as ever - successful breastfeeding is not just about the ounces, is it? :)
Heather Welford Neil
NCT bfc, tutor, UK
--
http://www.heatherwelford.co.uk
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