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Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 7 Jul 1999 21:53:42 EDT
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Nancy writes,

<< Breastfeeding IS much less stressful than bottle feeding, but each study
 comparing the two has noted that breastfed infants (and cup-fed, finger-fed,
 etc.) actually take in less at each feeding - a point that is of great
 concern to neonatologists - even me. >>

The question then is -- is there a REASON why babies are taking less?  Can we
really compare volume taken of formula to volume taken of breastmilk?  Are
they the same?  Of course not....we are comparing two entirely different
fluids.  So then the question is, are we basing our expectations of the
amount the baby takes at bf on how much we think he "SHOULD" take of formula?
 Which is normal?  At, say, 3 days of age, for a 7.5 pound infant, is taking
2 ounces of formula normal?  then should we expect the baby to take in 2
ounces of breastmilk?  Supposing we looked at all 3 day infants at 7.5 pounds
who are breastfeeding and calculated how much they took in -- after all,
breastfeeding FROM THE BREAST is normal -- not taking in a man-made,
artificial substance from a bottle.

The mothers will tell me, "Oh he takes 4 ounces of formula from the bottle."
then we do a pre post weight and he takes in 3 ounces.  Should I be
concerned?  Upon what guidelines should I base how much he SHOULD be taking?
120 kcal/kg/body weight/24 hours (or thereabouts?)  Or is there a different
measurement we should use for human milk?

I know that if the baby takes 2 ounces of Sim w/iron he is taking in 40
calories.  What I don't know is if the baby who breastfeeds, and takes in 2
ounces of breastmilk -- how many calories has that baby consumed.  Don't have
a clue.  It may be more, it may be less.  But it is HIS milk, designed by HIS
mother for HIS body....

At some point the trust factor has to figure in, and we can't look at what we
have designed for artificial feedings and assume the same for human milk
feeds.

I realize we don't have anything better at the moment, but....

Jan -- who had a mom of a preterm baby who had been burned, was in the burn
unit at one of our hospitals -- her milk was tested 3 times.  (At this point
the baby was up to 36 weeks gestational age).  Her milk the first time came
out at 27 cal/ounce; the second time at 29 cal/ounce; the third time at 30
cal/ounce.  The staff decided maybe the baby didn't need special 24 cal/ounce
formula.

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