I agree with your concern about an implied upper limit with the way 
these recommendations are usually stated.  A better way to put it 
might be "wt gain should be *in the range of* 4-8 oz/week" and 
similarly with the number of nursings.

If only the rock-bottom minimum number was stated, though, I fear 
that people would start aiming for those numbers and feeling (even 
more) uncomfortable with higher ones.  A mom whose baby nurses 14 
times might think, gee, my baby is nursing *almost twice as often* as 
recommended -- not realizing/remembering that the number 8 is a 
minimum.

I actually thought the AAP statement said *at least* 8 to 12 times in 
24 hours . . . but just double checked, and indeed, it simply says 
"mothers should be encouraged to have 8 to 12 feedings at the 
breast."  I do talk with many mothers whose babies feed much more 
frequently than this, and some do think they're doing something 
wrong.  Clearer wording would help.

Semantically yours,
Margaret
Longmont, CO

>I just have a comment/question about some of the commonly-heard 
>guidelines or standards for breastfeeding. Why do we say things like 
>"weight gain should be 4 to 8 ounces a week?" What if the baby gains 
>8.5 ounces or 9 ounces or 12 ounces in a week? Is that a problem? 
>I've certainly seen healthy, normal babies gaining at that rate. And 
>I've also heard of doctors telling mothers that their 
>exclusively-breastfed babies were gaining too fast because they were 
>over the expected "8 ounces per week" and that they needed to 
>restrict feedings to keep the weight gain down. I know this is not 
>good. So why don't we just say "at least 4 ounces per week?"
>
>(I supposed we could, if we wanted, add something like "the average 
>weight gain is 7 or 8 ounces per week" if that's what it is.)
>
>Another example - the statement that breastfed babies should nurse 8 
>to 12 times in 24 hours. I recently had a call from a mother whose 
>doctor told her she had to supplement because her baby nursed 14 
>times in 24 hours and that meant she didn't have enough milk. He 
>actually showed her these guidelines. Is anyone on this list 
>concerned about a baby who nurses 14 times a day? 20 times a day? 35 
>times a day? We know that short frequent feedings are the norm in 
>tribal societies. So why don't we make this guideline say "at least 
>8 times a day?"
>
>Having these ranges suggests an  upper limit when I don't believe 
>the evidence supports that upper limit. Anyone else have thoughts on 
>this?
>
>Teresa Pitman

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