Brenda writes:
I work as the Breastfeeding Coordiantor in a WIC office, and here in my
town
we are seeing an unusual amount of failure to thrive in older babies.
According to one pediatrician I spoke to this weekend, many of them are
breastfed older babies (the pediatrician is a lactation consultant).  I
may
be helping her with some of these cases, and am wondering if any of the
LCs
and/or dieticians have experience dealing with these clients.  The cases
where older babies (i.e. babies over 5-6 months of age, and often over 1
year old) refuse to eat solids and only want to nurse constantly.  These
are
cases where the infants are "falling off" the growth charts.

Hi Brenda!  2 things you might want to consider immediately came to mind
-
1)  I can't prove it (since we can't seem to get those Breastfed Growth
Charts) but in my 9 years as a LLL Leader, I've seen that a downward
trend in the growth charts is very common in the second half of the first
year.  My own 3 babies all dropped from over 90% at 6 months to around
40-50% at one year.  It is also very common for babies not to eat any
substantial amount of other foods for 9 months to a year rather than 6
months, and my personal guess is that the healthy age to start solids may
be older than we currently think - I'm not sure what the six month
guideline is based upon.  My personal experience, again, of when my
children really ate (as opposed to tasting for fun) was 12 months, 6
months and 11 months.  Not to say that some babies aren't really in
trouble, but that FTT may be overdiagnosed.  I believe there has been at
least 1 study of older babies not on solids - does anyone know more?
2) The other possible piece of the puzzle that springs to mind
(especially when you say 'unusual number') is the possibility that
scheduled, rather than on-demand, feedings may cause insufficient supply
not in the first weeks but in the later months.  A recent article in
Breastfeeding Abstracts discussed the physiological process involved.
('Cue Feeding: Wisdom and Science', Lisa Marasco & Jan Barger, May 1999).
Hope this helps,
Marcia McCoy
gotta go now and grout my tub enclosure

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html