Perhaps the ideal world is for all mothers to be at home with their baby for the first year and nurse on demand, offer solids after 6 months, and their baby would thrive. No numbers necessary.
In reality, most mothers do go back to work. It’s not my place to judge their choice, but maybe it wasn’t their choice. Either way, some of them find their supply goes down.
Some babies fail to thrive, whether home with mom or taking breastmilk bottles at daycare. My pediatric partners refer them to me. I can’t tell them to just nurse more if I don’t have a bit of data (numbers).
In Africa, some mothers simply don’t have time to nurse baby number 6, as they operate the farm and run the household.
So these mothers (and doctors) seek answers. I definitely individualize their management, but everyone wants a reference point (number).
When I evaluate a malnourished 7 month old, the easiest “test” to rule out a few bad diagnoses is to prove they can gain weight if given more calories. It’s cheap and painless. I also have to consider their intake of Ca++, protein, iron, and Vitamin A (in Africa).
When a mom is distraught because her supply is dropping at work, if I can somehow figure out how much she IS producing, she can try to recover it or be OK with “breastfeeding doesn’t have to be all or nothing.”
It is often assumed that all mothers in Africa breastfeed their babies, and we should do how they do. Their breastfeeding rates are no better than ours (based on very little research), but the consequences are much more dire.
Charts are a public health tool used to give guidance to the masses, ie reference points. If you search HealthyChildren.org, the AAP’s premier online parenting resource, you won’t find specific answers such as I tried to extrapolate from the WHO document. I simply tried to help with some reference points to answer the original question – 32oz/day for a 10mo old? I think the WHO is a reliable source of information.
Being able to nurse on demand for a year isn’t reality for everyone. It certainly wasn’t for me 25 yrs ago. I was a resident and had to be away from my baby every 3rd or 4th night, for about 36 hours at a time from 6 weeks through 6 months. I pumped like a mad woman. I wish it were different, but that was my reality.
I didn’t create the issues these mothers are dealing with, but I get it. And just as you all are, I’m certainly on board to help them deal with their situation any way I can.
Thanks for all the interesting comments and for reading!
Kay Anderson, MD, IBCLC.
Nebraska
> On Jun 25, 2018, at 3:59 PM, Laura Monin <[log in to unmask]> wrote:
>
> Seems like our bottlefeeding culture is now dictating how we breastfeed.
> My three nurslings now 45, 42 and 38 y.o. breastfed for food, love, and comforting. The last one didn’t even start solids till 8 months old!
> Couldn’t tell you how many times a day they each breastfed?
> They all thrived in their own rates of growth.
> Babies don’t wear iPhone watches to enable them to tell their moms when they should breastfeed. Hopefully there are still moms out there who don’t expect their babies to voluntarily restrict their feedings.
> Laura Monin
> IBCLC Certified 1979 through 2017
>
> Sent from my iPhone
>
>> On Jun 24, 2018, at 7:56 PM, Ellen Rubin <[log in to unmask]> wrote:
>>
>> I too would not have counted how frequently my nurslings fed at 10 month old, but I would guess as often as they did prior to 6 months so 8 - 12 times at least.
>>
>> Ellen
>>
>> Ellen J. Rubin, MA, IBCLC, LLL
>>
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