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Date: | Sun, 23 Aug 2009 09:15:16 -0400 |
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Dear all:
I haven't attended an IBCLC conference in a couple of years because air fare is expensive
and the economy is tight. So, I don't consider myself especially up to date. Cathy Genna
posted something on Lactnet that was at least a year ago giving at least four references
for the fact that the fat content doesn't matter, it is the volume of milk that influences
growth. I remember one study in particular in Africa where the mothers with the lowest
fat content had the babies that grew the fastest because their babies were drinking a
greater volume of milk. Now, I think if I had enough time to really explore that article,
the actual difference in fat content may not have been biologically important. Just
because something is statistically significant, doesn't mean it is of biological importance.
The knowledge that the fat content is a continuum has been around since I started taking
infant and young child nutrition classes in the 1980s.
And I don't see anything that really is NEW in these discussions. We've always know that
infants and mothers vary. Therefore, you cannot apply "rules" such as x amount of time
on a breast or "always/never switch breasts".
You can apply general parameters to keep an eye on things. A baby that feeds for 2
hours and only takes a 15 minute break to return to eating again --- is a baby that you
might want to keep an eye on. A baby that eats 4 times a day for 10 minutes each time
is also a baby that you might want to keep an eye on.
But --- to make one standard rule based on time makes no sense. The more important
information is how the baby is swallowing and behaving. Mothers should be assisted to
start honing their observations skills (which are usually better than they or anyone else
thinks they are) and to use these skills to develop a relationship in which they and their
babies respond appropriately to each other and INTERACT.
In my small little corner of the planet, mothers describe when their babies are not
swallowing as "using me like a pacifier". Invariably I find that they really do spot when
the baby is "no longer swallowing while sucking". This can be used to reinforce that the
mother has good observational skills and to then, depending upon the baby help her judge
what her response will be.
Best, Susan Burger
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