Barbara points out:
<<  This has clinical implications, obviously, for the slow
 gaining infant whose mother perhaps does not understand that you can deliver
 the same vol. of milk from the breast in a 24 hr period in 6 or in 10 feeds,
 and achieve better growth on with more freq. feeds due to this issue of
 higher caloric value of the milk.  >>

Which brings us to the point that in breastfeeding, it is not "how much" the
baby is getting nearly as much as it is "what" the baby is getting.   Which
is why a test weight only tells us half the story -- we may be able to
determine volume, but we certainly don't know if baby's intake was 3 ounces
of 20 cal/ounce food or 2 ounces of 25 cal/ounce.  Makes it difficult to
explain to mom when she says, "but the baby wants to eat again after an hour
and a half and I just don't have any thing there until at least 3 hrs."
While she may hear me when I tell her that while the volume won't be as great
the caloric value is higher -- often times I don't think they really believe
that.  We are so used to measuring volume of a consistent substance
(formula), and of course, most of our texts talk about human milk being 20
calories/ounce too -- regardless of length of time between feeds, age of
baby, etc etc.

Jan Barger, RN, MA, IBCLC
Wheaton, IL -- whre there is snow on the ground!

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