Laura asks about advice given in an MCH book which reads:

<< The answer in the book is "Frequent feedings, every 2-3 hours; sufficient
 length, with 10-15 minutes at each breast; adequate maternal nutrition and
 fluid intake; adequate maternal rest."

 Would love to hear everyone's comments on these 2 issues. >>

Babies don't watch clocks.  They don't know they are supposed to eat at a
certain time, and they might be sound asleep then.  The implication is that
if the baby wants to breastfeed at 1.5 hours, then you should wait until 2 to
3 hours....I would recommend making sure the baby nurses at least 8 to 12
times in 24 hours, when the baby shows feeding cues.  If the baby is long on
sleep & short on feeding cues, then begin the waking process 1.5 hours or so
from the end of the last feeding.  If she waits for 3 hours to feed, likely
she isn't going to get in even 8 feeds.

How do you MAKE a baby breastfeed for a certain number of minutes.  When was
the last time anyone asked any one of us "how long did you eat lunch?"  And
what difference would it make anyway?  I can consume 250 calories in 5
minutes, or I can consume the same amount in 20 minutes.  Time bears no
relationship whatsoever to the amount of food I eat.  And it doesn't with
babies either.  What's to say that 15 minutes at the breast is adequate for
THIS baby?  And can the mother/nurse distinguish the difference between being
"at" the breast, or breastFEEDING?  In 10 minutes, one baby may take in 6 cc
if there is inadequate milk production; the baby is an ineffective nurser, or
she's basically sleeping.  Another baby may take in 3 ounces in 10 minutes.
You can encourage longer breastFEEDINGS by breast compression -- that will
help.  But you can't MAKE a baby breastFEED for 15 minutes.  Doesn't work
like that.

What is the definition of adequate rest, adequate nutrition, and adequate
fluids?  Who defines "adequate?"  And what about women in countries where we
in the industrialized nations would consider their diets "inadequate?"  Can
they not breastfeed?  Or produce enough milk for their babies?  I don't think
so.

Unfortunately, most of the books I've seen written for MCH nursing students
are woefully inadequate in the area of breastfeeding.  The one exception may
be the one that Mary Rose Tully & Mary Overfield had a hand in helping write
(but I don't remember the name of it).  My daughter's book, circa 1994, was
absolutely HOPELESS.  And when Jill would tell me what had been said about
breastfeeding in her OB classes, she would about have to hold me down to
prevent me from doing bodily harm to someone or something.

BTW, saw a mom this morning who is on the fence about breastfeeding/formula
feeding.  I tried to querie her a bit about the indecision.  Well, it turns
out, her mother, a cardiac care RN, had told her that breastfeeding was just
awful -- that women got lumps in their breasts, they bled, they were in
excruciating pain all the time, that it was basically a dreadful experience.

What hope do I have in trying to sway her opinion?  (Right now, not much).

Jan B, in cold & blustery Wheaton

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