Jan writes:

>  I do think that babies that drink out of
> bottles tend to take a lot more than babies who are breastfeeding (whether it is
> EBM or the other stuff).  I think it's in the mechanics of bottle feeding ...
>  It's also one of the reasons many moms panic, thinking they can't
> possibly be making enough for their babies (particularly newborns) who will
> guzzle three or four ounces from a bottle, when all she can pump is 2 ounces.

During my 10 years in private practice, I spent a lot of time talking to new mothers about this difference.  IMHO it should be a routine part of our breastfeeding education and a vital "reframing" of the information mothers hear elsewhere.

Here's the approach I eventually developed:  "You know how we as adults are told that it is healthier to eat slowly so that our 'appetite control' mechanism kicks in before we overeat?  This also applies to babies.  When babies breastfeed, they develop healthy eating habits.  They tend to take small amounts at feedings and feed
more times per day.  Newborns breastfeed an average of 8-12 times per day.  Bottle-feeding, on the other hand, whether it is human milk or artificial milk in the bottle, sets up an 'overfeeding habit.'  Babies take more at a feeding and feed fewer times per day, usually 6-8 on the bottle as opposed to 8-12 on the breast.   A
newborn will probably take about the same amount of milk in a 24 hour day whether breast or bottle-fed, but it will be proportioned very differently, depending on feeding method.  Some researchers believe that the habitual overfeeding the bottle promotes contributes to obesity later in life."

With mothers going back to work, I also explain the above and let them know that if their baby takes more from a bottle, they will need fewer feedings overall, so this will ultimately balance out in terms of how much milk they need to provide while they're away.

Along the same lines, I'm noticing that many mother I talk to (as well as their medical advisors) have turned the old expression "formula takes longer to digest than breast milk" into a reason to give formula.  Many mothers have told me that friends and MDs have suggested they give a bottle of formula at night "to help their
babies sleep longer."  A mother called me just this week and told me she was weaning her baby, because she and her husband had decided to put her baby on a schedule and knew that "formula takes longer to digest than breast milk."  She also told me she did not want to give her baby any of the breast milk she had pumped during
weaning because her baby might want to feed sooner than the schedule allowed (!!!)

I told her that it was true that anything given in a bottle (human milk or formula) would keep a baby full longer, because of the "overfeeding" issue.  I also told her that "harder to digest" does not mean it will keep a baby full longer.  It means that the baby is at higher risk for digestive problems such as constipation and
gastro-intestinal illnesses.  I also encouraged her to give her baby her pumped milk because that was the only place he would receive any protection from illness.  Formula has no antibodies!

Did she rethink her plan?  I doubt it.  But I'm hoping that if we all start reframing (or "Wiessingerizing") some of these statements, we may eventually make some headway.

Here's hoping....

Nancy Mohrbacher, IBCLC
Chicago suburbs, Illinois, USA
where we got our first sprinkling of snow unusually early and the weather is crisp and cold

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