Dear Colleagues:
         The evidence from the  Cooper study( Pediatrics 1995; 96:957-960), 
and from the babies that survived  the earthquake in Mexico tells us that wet 
diapers tell only that the kidneys  are working; they are no index of 
breastfeeding sufficiency. The authors of the  Cooper study, reporting on severe 
breastfeeding malnutrition, say "Most of the  reports describe parents who are 
unaware of the progressive malnutrition and  dehydration, since their babies are 
quiet, sleep well, and have seemingly normal  urine output." The infants in the 
Mexican earthquake of 1985 were trapped in the  rubble of the hospital nursery 
for nine days; all were still peeing.
         The indicators  mothers can use to show breastfeeding sufficiency 
are infant weight  gain and infant stooling patterns: color change and amount 
and frequency.
         warmly,
 
Nikki Lee RN, MS, Mother of 2, IBCLC, CCE
Maternal-Child Adjunct  Faculty Union Institute and University
Film Reviews Editor, Journal of Human  Lactation
www.breastfeedingalwaysbest.com

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