Yaffa and others;

Yesterday I had a talk with a neonatologist about the issue of bottles and
breastfed babies.  He had some interesting and valid concerns about the need
to supplement.  I didn't get far on the issue of bottles but we did come to
agreement on some issues and I think the door is still open for future
discussions.

What I wanted to say is that he feels that the baby who is only peeing 2
times a day on day 2 is borderline getting into trouble.  A really healthy,
hydrated newborn, who has all the fluid stores we are taught they should have
will pee more than that.

I too see a lot of bottle use and supplementation in addition to a lot of
panicky mothers who have a hard time assessing the baby.  His suggestion was
that before the milk comes in baby should have 1 pee and 1 poopy diaper in an
8 hour period.  If there is none the baby needs to have a supplement.  Then
begins the next 8 hour period, if no pee or poop another supplement.
 Breastfeeding should continue every 2-3 hours throughout these 8 hour
periods and always right before any supplement is given (regardless of how
its given).  He feels that once the milk is in the baby will begin peeing and
pooping and the question of need to supplement will resolve itself because
there should be pee and poop in each 8 hour period.

This doctor believes that a very large percentage (95%) of the babies born at
this hospital are given bottles before going home.  Since our breastfeeding
initiation rate is about 85-90% during the first week he questions the
negative effects of bottle use.  The only way we found common ground on this
was when I offered to begin asking about any bottle use since birth and start
tracking the data as well as follow-up data on breastfeeding outcome.

It was an interesting meeting.  And yes Yaffa it was and is an ongoing
frustration.  One issue we discussed in some depth was the cultural context
in which we live and what the psycological impact of bottles can be to a
mother.

Denise Parker