I wonder if anyone can help me with some references.  I am trying to write
a letter to one of the Pediatricians who has been giving out these handouts
regarding "Trained Night Feeders."  What makes it especially distressing is
that this is a Ped who La Leche League Leaders have been referring to for
years because she was not quick to take a baby off the breast or insist
that a slower-than-average gaining baby needed supplementation.  She has
always been a breastfeeding advocate.

According to this handout, a "trained night feeder" is over 4 months old
and still cries one or more times at night to be fed.  In nursing babies it
is apparently caused by nursing the baby to sleep instead of putting baby
to bed awake, and by feeding often during the day.  The way you fix the
"problem" is to gradually lengthen the time between daytime feedings to 4
hours or more, put baby in the crib drowsy but awake, pat the baby's back
every 5 minutes if it cries at bedtime but don't take it out of the crib,
cut nighttime feedings to one--only after a 4 hour interval, and then phase
out the nighttime feeding altogether.

The handout states:  "Your goal for a formula-fed baby is to give him four
meals a day by 4 months of age.  Breast-fed [sic] babies often need five
feedings each day until they are 6 months old, when solid foods are added
to their diet."

Now I know this is totally insane; she might as well give the mom this
handout and say "here--you'll be weaning your baby now" which I don't think
is at all what she intends.  I think there are MANY good reasons for not
following this advice, but what I'd like to be able to share with her are
some concise references on why this is physiologically not possible for
most women, that we NEED to feed more than 5 times/day in order to maintain
an adequate milk supply.  I'm having difficulty coming up with something
that talks about "maintaining a milk supply" that is medically oriented.

I have the basic references--Ruth Lawrence, Riordan & Auerbach, Kathy
Dettwyler, etc. but I can't seem to find what I need.  If anyone can think
of a good source for this info I would be eternally grateful.  Has anyone
else dealt with this handout?  It's copyrighted by "Clinical Reference
Systems Ltd." but not referenced.

Becky Krumwiede, RN, IBCLC, Appleton, WI
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