<< Severe malnutrition in the
 first year of life, even if corrected later, is associated with intelligence
 deficiencies at age 11 to 18 years." Has anyone seen any literature
 cooraborating this statement? >>

i too would really like to know more about this. parents often ask, when they
have a weight gain problem with the baby, if they have damaged their baby. my
understanding previously has been that in the short term (days or weeks) that
if a baby is holding his own, that is, if he is not losing weight, even if he
is not gaining, then no permanent damage has been done (and of course the
idea is that from that particular day forward food intake will be adequate).
the typical story is a baby who does not regain birth weight within a few
days (maybe is seen on day ten) but who with help begins gaining from that
point on.

the harder ones to figure out are the ones where the baby gains but so very
slowly, over months, and is self-limiting intake, and various strategies
aren't working like we hope.

this is a topic i would like to know more about, and two others that i find
very interesting are, how long does it take for engorgement to do damage to
the breast? and the point barbara raised about a baby who is a poor feeder at
day three may be at risk for continuing to be a poor feeder from then on
(need to read the study, obviously). these two topics make me look even more
closely at moms and babies i see with engorgement or problems at day three.

for instance, if a mom is engorged, but milk flows freely and baby is nursing
well and she pumps some to relieve engorgement but experiences pain for 24-48
hours, could that cause permanent damage? i would like to think not. the ones
who get so engorged that they cannot get the milk out, these are the ones who
cause me to worry about permanent damage.

unfortunately i hear many mothers here say they have been told "let your
breasts fill up between feedings," i have even had nurses patiently explain
to me that the mother "must let the reservoir get full." full of what? trout?

carol brussel IBCLC
wishin to be fishin

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