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Subject:
From:
Sue Pace <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 30 Nov 2008 09:31:31 +1300
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Try reading some of Gill Rapley's work in the UK-Baby led weaning (as in
baby directs the pace of eating food) whilst maintaining full milk
feedings.

I think Nursing first in the first year is a very helpful way of guiding
mums with how what and when and the emphasis on family foods being
complimentary to milk in the first year. 

 

Sue Pace

Midwife/BFHI Coordinator/IBCLC

NZ

 

 

-----Original Message-----
From: Susan Burger [mailto:[log in to unmask]] 
Sent: Saturday, 29 November 2008 9:49 AM
Subject: Re: Please read posts carefully.

 

Dear all:

 

 

I must admit that I feel quite exasperated at the moment.  I do wish
people read what I 

ACTUALLY write.  No one on Lactnet suggested that anyone who is
concerned about the 

over-feeding issue are extremists, not even me.  So to put up a defense
to that effect 

seems as if my post was completely misread.  

 

I want to make it very clear that what I wrote in my post about Kay
Dewey's work was 

that the "ORDER" of which comes first did not make as much of a
difference as the 

NUMBER OF FEEDS". 

 

Kathryn Dewey is a well-respected researcher and part of the UC Davis
group that did the 

work that ultimately debunked the 4-6 month for introduction of solids
and nailed it to 

"around 6 months".  Without the work of the UC Davis group we would not
be able to 

dispute the introduction of solids excellent work on breastfeeding which
is both copious 

and extremely well designed.  Therefore, we'd be combatting even more
infants being 

stuffed with solids from 4 months of age onward than we already do.  She
also worked on 

the data that became the basis of the new WHO charts that are now based
on HEALTHY 

NORMALLY feeding infants.

 

I looked up Kathryn Dewey's reference to the study which WAS by Juan
Rivera et al, 

1999.  It showed that when they promoted 5 meals per day, the
breastfeeding frequency 

(per 12 hours) and the breastfeeding duration (per 12 hours) declined
and was 

statistically significant among infants 6-12 months of age.  In her
presentation at the 

Academ, she did not include the full reference, but knowing Juan's work
you will probably 

end up with lots of references on infant feeding that would be well
worth reading while 

you track down this one particular study showing that too many meals
reduces the 

frequency and amount of breastfeeding.  This is peer-reviewed evidence
that gives 

guidance support appropriate practices that are more likely to IMPROVE
breastfeeding 

frequency and duration.

 

Much of what is written about infant feeding is based on OPINIONS and
THEORIES that 

may or may not actually improve the frequency and duration of
breastfeeding in the 

second half of the first year of life. Moreover the lack of an impact on
breastfeeding 

frequency and duration regardless of whether breast or food was offered
first doesn't 

should not be extrapolated into a statement that I never made. NEITHER
KATHRYN 

DEWEY, NOR I said that there was anything wrong with offering the breast
first, nor 

would I conclude that from the paper.  

 

I do, however, think this research suggests we are likely to have better
results if we 

focus more on an appropriate rhythm for spreading out the introduction
of additional 

"meals" of solids. Mothers should not be trying to get six month olds to
eat three meals 

of solids a day, nor nine month olds to be eating five meals of solids a
day.  Focusing on 

the gradual introduction of small taste testings and a gradual increase
over the 2nd half 

of the first year as well as responding to other physiological cues is
likely to cut down on 

the overfeeding that occurs when mothers feel that more meals is
progress.

 

The similarity between the two situations is not in the enormity of the
consequences, but 

in the approach.

 

Best regards, Susan E. Burger, MHS, PhD, IBCLC

 

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