Hi,
We are in the process of revising the feeding behaviors/diet intake form
for infants.  Right now we're looking at the parameters for BFing infants.
There seems to be quite a bit of controversy on 2 issues in particular - 1)
whether to use iron-fortified or low-iron human milk substitute (HMS)
with infants who are BFing, and 2) the number of messy diapers that
would indicate adequate intake for BFing infants.  The way our form has
been designed, the ages for infants assessed are 0 through 3 mos., 4
through 6 mos., and 7 through 11 mos.

1) Currently BFing  infants who recive supplements receive Fe-fortified
HMS.  I have a couple of references for using low-iron HMS for BFing
infants during the 1st 6 mos.  I've also read R. Lawrence's
recommendation for using lo-Fe HMS for BFing infants, though the
amount the infant is BFing is not stated.  One of my colleagues has asked
"what about when the baby is only getting one BFing/day?"  My
response was that the baby probably wouldn't be BFing very much
longer, if that was the case (during the 1st 6 mos.) and by the next
month would probably be on HMS completely.   I couldn't find any policy
statements supporting one type of  HMS (Fe-fortified or lo-Fe) over the
other.  All that I've found is that BFing is recommended exclusively for the
1st 4-6 mos. of life and if mother does not BF, use Fe-fortified HMS;
nothing about supplemental use of HMS.

2) Stooling patterns - I've seen  the following listed for stools for 1st 6
wks :
  at least 4 seedy stools/day,
 with every feeding,
 at least 1x/24 hrs
 frequent,
 2-5/day,
 at least 3, and
 5-10.
After the first 6 weeks
every 3-4 days,
every few days or once/week,
once every day
every 4-12 days (copious).

As you can see there are numerous guidelines out there.  If anyone can
help narrow these down (references would be greatly appreciated),
please let me know.

Thanks for your time,

Debbie McClurg-Hitt