I just have a comment/question about some of the commonly-heard guidelines 
or standards for breastfeeding. Why do we say things like "weight gain 
should be 4 to 8 ounces a week?" What if the baby gains 8.5 ounces or 9 
ounces or 12 ounces in a week? Is that a problem? I've certainly seen 
healthy, normal babies gaining at that rate. And I've also heard of doctors 
telling mothers that their exclusively-breastfed babies were gaining too 
fast because they were over the expected "8 ounces per week" and that they 
needed to restrict feedings to keep the weight gain down. I know this is not 
good. So why don't we just say "at least 4 ounces per week?"

(I supposed we could, if we wanted, add something like "the average weight 
gain is 7 or 8 ounces per week" if that's what it is.)

Another example - the statement that breastfed babies should nurse 8 to 12 
times in 24 hours. I recently had a call from a mother whose doctor told her 
she had to supplement because her baby nursed 14 times in 24 hours and that 
meant she didn't have enough milk. He actually showed her these guidelines. 
Is anyone on this list concerned about a baby who nurses 14 times a day? 20 
times a day? 35 times a day? We know that short frequent feedings are the 
norm in tribal societies. So why don't we make this guideline say "at least 
8 times a day?"

Having these ranges suggests an  upper limit when I don't believe the 
evidence supports that upper limit. Anyone else have thoughts on this?

Teresa Pitman 

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