Nancy Wight, MD, was one of the speakers who I saw at a conference lately and 
she gave me some great advise.  Before I get to her advise, just a quick 
background of my question.

I brought up on LACTNET a few weeks ago about the Ross rep coming on our unit 
and offering breastfeeding literature.  I asked him for formula feeding 
literature.  What he gave me was pathetic, one booklet that they wrote on 
breastfeeding with the last 4 pages on formula feeding.  What I found there and all 
other handouts to parents regarding formula feeding is this: give 1-2 oz every 3 
hours the first day of life and then 2-4 oz or ad lib every 3 hours for the 
next several days.  They state to place the baby semi-reclined and keep the 
bottle tipped with the nipple filled at all times to prevent excessive air intact. 
 Then to stop after 15-30 cc to burp the baby.  Nothing is said about using 
rooting to determine readiness of a baby or how to determine if the baby is 
tolerating the flow.  

So back to Nancy's answer; she told me make those who give this advise to 
back it up with documentation.  This cannot be antidotal but with science behind 
it.
The evidence is there that the normal intakes of the newborn on day one are 
7-10 cc per feeding with an average of 6-8 feedings in the first 24 hours.  In 
the second day of life the average intake is 10-30cc per feeding with 8-12 
feedings/day.  Babies have the rooting reflex to communicate desire to suckle.  
Some babies need more suckling than others and what Peter Hartman just told us 
that babies learn how much they get from their mothers and adjust to more 
frequent nursing or less frequent.
We all need to ask those who insist that the material and teaching of formula 
feeding is correct, to give us the proof to back this.
I keep telling the staff that breastfeeding is the norm for the newborn and 
they do not come out and become another species because they are given formula.
If those who choose to give formula or promote it find this task difficult, 
well that is the way it should be.  
We in the breastfeeding community will continue to hit our heads against the 
wall until we get the word out that breastfeeding is the "norm" for infants 
and everything else has to mimic it.
Ann Perry, RN IBCLC
Boston, MA

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