Carmen writes about the benefits of an accurate scale, used accurately.

Carmen, I wonder if I can respectfully suggest an alternative way of 
supporting breastfeeding in  the babies who are not gaining as 
expected. You say:
>
>
>   When babies on the contrary, are not gaining properly and I do not 
>see a proper intake, I do encourage the parent to supplement in 
>cojunction with bf in every feeding.  I also suggest the amount of 
>ounces the baby should be receiving in every feeding according to 
>the baby's weight.  As the baby's intake increases (test weight 
>weekly checking), we decrease the supplementation.  I have seen many 
>successful bf experiences, who might otherwise had probably given up 
>and wean.


I take it these babies are basically healthy and there is no organic 
reason for their poor weight gain. All they are lacking is calories. 
So.....the calories are, as we know, in the mother. Another way of 
supporting appropriate weight gain is to give the baby more access to 
these calories, by feeding effectively, and more often. Many healthy, 
bf babies do not have separate, documentable feedings. On the 
contrary, it is normal for babies to 'cluster feed' and for the 
mother not to know the beginning and end of each feed for sure.

Holding the baby close, skin to skin when possible, offering more 
opportunities to take the breast, and not waiting for the clock, or 
the baby's cries, to mark the start of a breastfeed means four things 
happen

i) the baby takes in more breastmilk
ii) the mother makes more breastmilk
iii) the mother realises that she alone can 'grow' the baby
iv) the risks of supplementation, to the baby's health, and to the 
continuance of breastfeeding, are avoided

Supplementing at every feed is risky, though some babies may of 
course need this. I  understand you say you have seen successful 
experiences, and there is no doubt that some mothers and babies can 
continue breastfeeding despite the frequent supplementation. I wonder 
if it is your encouragement and close support and monitoring that 
maintains the breastfeeding, rather than the supplementation per se? 
:)

Heather Welford Neil
NCT bfc, tutor, UK

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