Hi Karleen,
I am shocked, but on the other hand not surprised. Recommended weights have
been gradually creeping up. That figure would ensure that even more babies
are put onto artificial baby milks very early in life. I wonder how this is
being justified pyshiologically, because I think the onus of proof lies with
people who set figures.
Two of my own four babies wouldn't have made this level of gain. The first
one, when I had iatrogenic lactation failure, gained on human milk (donor
milk from another mother offered by staff, and a small amount of my own
milk), but her gains dropped off and flattened out when she was given two
different brands of cow's milk-based mixtures, eventually receiving the full
amount calculated of ABM. I relactated, thanks to LLL, and she resumed
gaining on my milk alone. All of my babies, except the first (who was being
topped up with artificial milk by the midwives), regained and exceeded their
birthweights by 7 days. She took longer.
I don't have the records for the first 2-4 weeks for him, but the next baby
gained an average 120g per week (60 one week, 180g the next, on a regular
basis), and was ahead on other milestones. The nurse who weighed him wasn't
impressed! With the third baby, probably the biggest gains were while I was
tandem breastfeeding and I noticed he gained more in the weeks his brother
was more demanding, In weeks 2-4, his weight gain per week was 5.5 ounces
(165 g), and for the next two months it averaged at least 240g p/w. My
fourth baby fitted the figures Karleen cited, except for the gain for the
week to age 3 weeks (a respectable 180g). She was my best gainer, till she
fell off the graph around the time she started solids and gained very little
for several months. Reason unknown, but all her other milestones were met
and the child health nurse was happy with her progress, as was I. What
surprised me, when I dug out the baby books for my youngest two children
(the only complete baby records I still have), was how much they gained in
their early months.
Why am I citing this personal history? Because it shows a different story,
with babies who had other patterns. People working with babies tend to like
numbers and this number will be remembered, cited without question, and
applied - and babies who are doing nicely, being breastfed frequently enough
and transferring milk effectively, will be unnecessarily topped up. They
will be exposed to artificial food very early in life and the mother's
confidence in her body may be undermined.
I should now go and look at the paper cited. Karleen, do you have the
citation to share, please?
Virginia
Dr Virginia Thorley, OAM, PhD, IBCLC, FILCA
Brisbane, Queensland, Australia
On Tuesday Karleen Gribble wrote:
I have just been rereading Marianne Neifert's paper on lactational
insufficiency. I find it interesting that they determined that a woman was
not providing her baby with enough milk if they gained less than 200g a week
between weeks 2 and 4 of life. That seems to be too high as a cut off to me.
I would be interested in the opinion of Lactnetters.
Karleen Gribble
Australia
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