In response to my saying
<When I heard the theory that a woman's milk production stabilises in the
early weeks and then does not increase very much after it is set, I
looked
for ways that a baby can go on gaining weight if its intake doesn't
increase.>
Marsha Glass wrote:
<< I still use Riordan and Auerbach's information about the milk a baby
gets,
which states that, on average, babies get ~37 ml in first 24 hours, ~500
ml/day by day 5, ~750 ml/day by 3-5 months.>>
Dear Marsha,
Perhaps I was imprecise, and perhaps I should not have called it a theory.
I
based this statement on the same info as you, mainly on the chart that
appears on p. 124 in Riordan and Auerbach’s second edition (and on
p. 82 of
“Nutrition during lactation”). That chart shows average
milk intake as
determined in several studies that used test weighing with exclusively
breastfed infants. By one month it is 700 cc/day, at 6 months it is a
little
shy of 800. To me, this fits the description “does not increase
very much,”
especially if you plot it against the average baby’s weights at
one and six
months, which increase around 100%.
You say it doesn’t make sense to you that a baby doesn’t
take in
(significantly) more milk as it gets bigger. I know. It didn’t
make sense
to me either, and that’s why I began musing on what differences
there were
between one and six month old babies. Stool patterns were one thing I had
noticed in my own first born, and as La Leche League assured me that this
was
a normal finding for some breastfed babies, I developed a theory that
would
account for both a (relatively) stable milk intake and a change in
stooling
frequency. The fact that we are told that a baby’s gut lining
matures during
this time seemed to give credence to my theory---but it is still no more
than
a theory!
I am in staunch agreement with you about the need for parents and
professionals to make their peace with the small amounts of colostrum and
early milk we see in many mothers on Days 1 and 2. One thing that makes
it
difficult to convince them is the fact that there are newborns who will
take
1, 2, 3, or even 4 ounces of fluid from a bottle at one sitting on their
first day—I know this from my years as a nurse in a hospital with
a 50%
breastfeeding rate, when the free formula supplies came in 4-ounce
bottles.
And not all of them puke it back up on the nurse!
Another piece of information that annoyingly seems not to fit the facts
is
what I’ve read about babies drinking amniotic fluid in utero—some of them
take in up to a pint a day! And then we claim their stomachs can’t
hold more
than a few ccs!
Aha! Writing this note has finally spurred me to do the math to help me
solve the latter problem! A pint a day is 480cc in 24 hours.
So…since we
know or suspect a fetus can swallow amniotic fluid any time it is sucking
and
it could be sucking off and on over the whole 24 hours...that works out to
an
intake of 20 cc an hour, or one teaspoon (5 cc) every 15 minutes. I can
easily imagine that amount fitting into the golf-ball-size fetal stomach.
The other point you bring up is ‘what we fondly refer to as growth
spurts.’
You could check the archives from April, 16, 1996, for my thoughts on
those,
under the subject “How much milk?”
I don’t know whether growth spurts are ‘out of vogue’ now, but I no longer
believe that they happen at somewhat predictable intervals (ref: a poster
by
Clara Aarts and others at recent ILCA conference) or that the baby is
building the milk supply to any great extent when they do happen. Maybe
the
baby boosts the supply by an ounce or so in 24 hours (say, from 750 to
780
cc), and maybe that’s all the extra milk the baby needs at that
time. More
frequent and longer feeds would also boost the baby’s fat intake
(see
Woolridge in Dettwyler and Stuart-Macadam’s book) and give the
baby more
opportunities for getting comfort. So that’s what I think is
going on when
babies increase their nursing on a short-term basis.
By the way, I agree with you about the ‘scissor hold.’
Whatever way the mom
holds the breast (or doesn’t hold the breast) doesn’t
matter to me as long
as the baby gets well latched, drains the breast well, and everybody’s comfy.
Regards,
Chris Mulford
Swarthmore PA
(Can you tell I have deadlines to meet, so am spending time having
Lactnet
fun instead of doing my work?)
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