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Subject:
From:
Margaret and Stewart Wills <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 19 Jan 2008 00:47:53 -0500
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The issue isn't the volume of colostrum available -- it's the number of 
feedings in those early days.  Several studies, cited in previous 
Lactnet discussions, noted that babies feeding at least 9-10 times every 
24 hours in those early days tended to have moderate bili counts.  And, 
for a variety of reasons, how commonly is *that* happening in most 
hospital settings?  The mothers don't feel full so they don't feel the 
urgency, and they're self-conscious about practicing in public,  Baby is 
bundled up away from mom, being passed around to relatives, and probably 
recovering from a birth with a chaser of  medications, so they're not 
asking.  So if someone is just feeding a few times a day, waiting to get 
home or for the "'real" milk to arrive, the colostrum intake doesn't 
total up into a the steady doses that keep a baby pooping.  Mother's 
don't need to be asking "Do I have enough milk?" but "Do I have enough 
feedings?"

Mother's need to know that the feedings aren't necessarily going to be 
at certain hourly intervals.  (Can't these babies read?!)  
Cluster-feeding is a time-honored tradition, that got lost for a few 
generations, when babies, wired for a *lot* of sucking to transition the 
milk supply, found themselves flooded with milk from a bottle on Day 1..

Even getting the baby to the breast frequently won't suffice if he/she 
is just sleeping, or is one of those "a little early" babies who can't 
drive the train yet.    So some of the vigilance about jaundice is 
warranted, but it seems that almost every baby I see in private practice 
has been supplemented for jaundice.

Margaret Wills, LLLL, IBCLC

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