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Subject:
From:
"Christina M. Smillie, MD, FAAP, IBCLC" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Fri, 25 Apr 2003 07:05:41 -0400
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The data I memorized a long time ago was that the average exclusively breastfed baby is reported to consume 750 to 850 cc/day or 24 to
28 oz/day, somewhat under a liter, and under a quart, a day. So right smack in the middle there, 800 cc times 70 cal/cc,  or 26 oz
times 20 calories per ounce, both standard figures tossed around-- will give you 560 cal or 520 cal.

That's more exact than you actually can be, because babies and mothers are so variable. Remember though that if a mom is making tons
of milk ("oversupply" or "hyperlactation") in response to mismanaged feeding advice (switching etc,) she will be making, on average, a
lot more skim milk, so she will have a larger volume but lower calorie milk, somewhat balancing the equation.  Although much of the
time the oversupply is a vicious cycle of hungry baby, not satiated by enough cream, coming back for more, and driving up production,
and many of these babies gain weight faster, on their high volume hi carb low fat diet, than if they had had a higher cream content
(another data point for Atkins!)-- so those moms will be using more calories.

A mother of twins could be making close to two liters a day, and 2.4 liters sounds like the output of a mother of triplets. Those
figures sound lie someones estimate of the maternal capacity, not average output for the mother of a singleton. Although, having seen
mothers overpump and with major hyperlactation, I think volume estimates of maximum human capacity may be even higher in MOMs.

You are right that there is also some caloric expenditure to make the milk. The biggest expenditure is with lactogenesis, while volume
is still small, and the biggest production volume then is in the first few months, and moms have stores from pregnancy in hips and
thighs to use up, so production calories can generally be seen as coming from those stores, or just from the variability in mom's
diet.

500 calories is a reasonable guestimate to give to a mom, if she asks. It should not be a rule for her to follow or get all analytical
about.

It is way better is to tell her simpy to eat to hunger and drink to thirst. The body takes care of this, if you need calories, it
gives you an appetite. Far better to teach a mom to listen to her own feeding cues than to go to all the trouble to teach her to watch
her baby for feeding cues, to get her away from worrying about her baby's intake by the ounce, only to turn around and make her
measure her own food. The only reason to throw around the number "500 calories" is for a mom who wants to lose weight, it gives her a
ballpark number to factor into the equation if she is going to ignore her appetite and eat to the numbers.

Tina Smillie

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