>Dear all:
>
>I wish I had Heather's experience of being able to count all the
>babies who truly are
>suffering negative health consequences on one hand. I would say I
>see a serious case at
>least once a month in my group --- often missed by other health care
>practitioners or
>falling through the cracks between visits. I also see cases where
>mother has received
>false reassurances because everyone dismissed the possibility that
>something was wrong
>because the baby was at the bottom of the weight gain "normal" limit.
>
>This is where focusing on the weights alone --- "oh, it's a little
>low, but within normal..."
>instead of how the baby is behaving (sleepy, lethargic, then moving on to miss
>developmental milestones), or mom's history (insulin resistance,
>etc) or care taking
>behaviors (sleep training, rigid schedules, pacifier use..) play a
>huge role in detecting
>what is really going on.
I totally agree with that, Susan....and to clarify, the true
*starvers* at 4 weeks we don't see, but we do see a lot of babies of
different ages who are not doing all that well but who tick along
without actually doing anything so alarming that anyone would
recognise an emergency. These babies are often not very happy, or
else they are 'good' babies who sleep 'well' but not so 'well' that
again, anyone would recognise something serious happening now.
Generally speaking, these are the babies where the discussion would
lie - I would say these babies do not need supplementing - they can
increase their intake of breastmilk easily enough if necessary and
the breastmilk supply responds. But it can be done not as an overt
'calorie increasing exercise' but just as a 'relationship enhancing'
exercise where mum learns it's ok to respond to cues and to initiate
opportunities to feed more.
The usual pattern of care in the UK is for mothers to take their
babies to the clinic weekly and to be in (at least) telephone contact
with their health visitors ad lib. This is not always a good thing,
but it does pick up the emergencies and clearly serious cases. We
don't have paeds laying down the law about how to care for babies -
most mothers and babies never see a paediatrician. Paediatricians
are for sick babies, and actually, *very* sick babies or babies
with on-going developmental problems. Most paeds do not work in
primary care. GPs can be very sabotaging of breastfeeding, sadly,
but *mostly* parents don't consult them on basic matters like
co-sleeping or solid foods (though HVs can give poor information on
both).
We don't have BabyWise, but we do have Gina Ford (Contented Little
Baby Book) but she is not as extreme as BabyWise and makes no
spurious claims for saving marriages and at least tells mothers not
to use her routines if the baby is gaining less than 6-8 oz a week.
Culture and context is so important.
> This IBCLC charges by the hour and often
>will stay for three hours chatting racking up $450 fees. I'm
>finally getting a family with
>twins back on track after they were told to "throw out the pump" in
>the first week when
>the twins were barely transfering milk with the expected result that
>mom ended up with a
>50% supply. She now coming closer to 100%. This type of "purist"
>approach without
>really evaluating what is going on can lead to completely unecessary
>use of formula. I
>know this mother of twins would have made enough had a proper
>assessment of milk
>transfer been made and had she been helped to remove the impediments
>to pumping
>efficiently.
Why is there no mechanism to prevent someone practising like this?
In the volunteer orgaisations, someone behaving in this way with
mothers and babies would be stopped.
Heather Welford Neil
NCT bfc, tutor
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