Dear all:


I must admit that I feel quite exasperated at the moment.  I do wish people read what I 
ACTUALLY write.  No one on Lactnet suggested that anyone who is concerned about the 
over-feeding issue are extremists, not even me.  So to put up a defense to that effect 
seems as if my post was completely misread.  

I want to make it very clear that what I wrote in my post about Kay Dewey's work was 
that the "ORDER" of which comes first did not make as much of a difference as the 
NUMBER OF FEEDS". 

Kathryn Dewey is a well-respected researcher and part of the UC Davis group that did the 
work that ultimately debunked the 4-6 month for introduction of solids and nailed it to 
"around 6 months".  Without the work of the UC Davis group we would not be able to 
dispute the introduction of solids excellent work on breastfeeding which is both copious 
and extremely well designed.  Therefore, we'd be combatting even more infants being 
stuffed with solids from 4 months of age onward than we already do.  She also worked on 
the data that became the basis of the new WHO charts that are now based on HEALTHY 
NORMALLY feeding infants.

I looked up Kathryn Dewey's reference to the study which WAS by Juan Rivera et al, 
1999.  It showed that when they promoted 5 meals per day, the breastfeeding frequency 
(per 12 hours) and the breastfeeding duration (per 12 hours) declined and was 
statistically significant among infants 6-12 months of age.  In her presentation at the 
Academ, she did not include the full reference, but knowing Juan's work you will probably 
end up with lots of references on infant feeding that would be well worth reading while 
you track down this one particular study showing that too many meals reduces the 
frequency and amount of breastfeeding.  This is peer-reviewed evidence that gives 
guidance support appropriate practices that are more likely to IMPROVE breastfeeding 
frequency and duration.

Much of what is written about infant feeding is based on OPINIONS and THEORIES that 
may or may not actually improve the frequency and duration of breastfeeding in the 
second half of the first year of life. Moreover the lack of an impact on breastfeeding 
frequency and duration regardless of whether breast or food was offered first doesn't 
should not be extrapolated into a statement that I never made. NEITHER KATHRYN 
DEWEY, NOR I said that there was anything wrong with offering the breast first, nor 
would I conclude that from the paper.  

I do, however, think this research suggests we are likely to have better results if we 
focus more on an appropriate rhythm for spreading out the introduction of additional 
"meals" of solids. Mothers should not be trying to get six month olds to eat three meals 
of solids a day, nor nine month olds to be eating five meals of solids a day.  Focusing on 
the gradual introduction of small taste testings and a gradual increase over the 2nd half 
of the first year as well as responding to other physiological cues is likely to cut down on 
the overfeeding that occurs when mothers feel that more meals is progress.

The similarity between the two situations is not in the enormity of the consequences, but 
in the approach.

Best regards, Susan E. Burger, MHS, PhD, IBCLC

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