I remember a slide that I use when teaching professionals about slow weight
gain vs. failure ot thrive. I'm thinking that the source is either from an
old Ruth Lawrence text or Nutrition in Infancy by Tsang and Nichols both
circa 1988. At any rate, in chart form it compares net milk intake of breast
fed babies fed  frequently 10 (+ or - 2) x per day as opposed to I believe 6
or 7 (+ or - 2) x per day.  There was approximately  a 180 -200 ml increase
in milk production and subsequent daily milk intake by the infants when moms
more often, much more than you would think by adding 2 feedings at breast

When I speak with moms of babies who are slow gainers - I typically say (in
my mind thinking of this slide)
"if you can get you baby to nurse 1-3  more times each day it can make all
the difference between borderline weight gain and good weight gain. This is
especailly true of course when you have ruled out other anatomic or organic
causes.

An while I'm posting just a question for those "baby friendly hosptials" out
there - or even if you have just a letter of intent. Our neonatologists
prefer to use a pacifier dipped in sugar water (which they make themselves
because the sterile bottled glucose water is not a 20% solution) for pain
relief during a circumcision. (Wonder if that meets CDC guidlines - but
that's a discussion for another time.)

They currently do not ask mothers permission to do this. We are looking to
at the BFHI as we speak and wonder if this practice of doing this would be
considered an exception to offering no pacifiers to infants or if there are
no exceptions to the " Ten Steps". As you know pain assessement is a biggie
with JCACHO now and our docs are pretty firmly committed to continuing this
practice.


LuAnn Smith RN, IBCLC
York, PA
Any comments fellow Lactners?


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