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Date: | Wed, 21 Mar 2007 11:05:09 EDT |
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Pam and others, I wanted to respond to this topic even though it was several
days ago that you posted.
I have and use the "belly balls" from Ameda. A picture can be so powerful
sometimes verses a verbal description. What I see fault in the belly balls is
that the stomach size or capacity is not what is really at the root of what
babies want or need in the first few days; it is about the physiological
norm.
So the nurses and doctors are correct in saying newborns fed bottles can and
do take more than 7-10 cc per feeding. Newborns can take 45-60cc sometimes
but watch out because we all know they will be spitting up for hours after
this. This the staff take as "normal" newborn behavior and do not think much
about what is happening to this poor new baby!
The basis behind what a newborn needs and wants is far more than stomach
capacity. The work from the 1920's paper is the foundation to the average
intakes of the newborn and authors such as Peter Hartman and others have added
onto this work. There have been pre and post weights to show how much a baby
consumes at different feedings at different days old. There has been
measurements of expressions from moms on each day postpartum and ultrasound
measurements by Peter Hartman's team. These all look to volume but there is another
piece to this puzzle. The composition of breast milk. Colostrum has 3 times
the protein of mature milk. The sugars and fats are lower than mature milk.
This high protein is what stabilizes the newborn's insulin without
overwhelming their poor delicate digestive system in the early days. To use Kcal/Kg to
determine the needs of a newborn to treat hypoglycemia is just not enough.
Of the 45cc of formula the newborn chugs, how much do they retain and use?
Because formula is an unchanging composition does it require a large volume to
treat hypoglycemia in newborns? There are studies showing skin to skin
alone stabilizes blood sugars for babies.
My understanding of newborn's needs and capacities is based some on the
literature and some on just basic physiological common sense.
A newborn is going through the most dramatic change in their life. This
adjustment from intro uterine life to extra uterine life could be compared to:
either what a woman's body is going through in labor or anyone coming our of
major surgery. In both the latter cases the human body is adjusting to what
is going on which leading to depressed appetite, slowing of the peristaltic
wave in the gut, and over all discomforts. Each person is different on how
they handle these scenarios and if they listen to their own bodies they will
know when they can advance in their diets. Some babies will breastfeeding often
and take more in than others. If truly observing the newborn for their
ability and willingness to feed, most take in what they need and remain stable.
Because of birth interventions, separation of mother and baby, the influence
of the formula industry, and lack of knowledge of many; the quantify and
quality of breast milk (including colostrum) is on trial.
So why do some newborns appear to be hungry and take large volumes of
formula? I have brought this up before on emails regarding bottle feeding so I
will make this brief. Almost everyone bottle feeds babies incorrectly. The
nipples are fast flowing, gravity is allowed to be used, babies want to suck but
both non nutritive sucking and nutritive sucking which allows larger volumes
of formula to be delivered to the poor baby's stomach, and there are many
babies that are basically force fed because this can easily be done with a
bottle.
Pam, remember breast milk and breastfeeding is the standard for babies.
When others tell you they do not believe this concept of smaller intakes in
newborns ask them to bring you the science to their argument.
Change is hard and takes a long time. We have to be patient but continue to
stay on course and the "belly balls" are helping to get that message out.
Any comments welcomed.
Ann Perry, RN, IBCLC
Boston, MA
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