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Subject:
From:
Rachel Myr <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 22 May 2013 01:43:01 +0200
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In the article on early limited formula supplementation to at-risk
infants, the authors refer to their previously published retrospective
cohort study in which a 5% weight loss in the first 36 hours was
predictive for 10% weight loss during hospital stay. But I agree, the
premise that a 5% weight loss should be the sign for initiating
measures we perhaps ought to reserve for when weight loss actually
gets to 10% is debatable. It is sort of like the fear of the number
25, which in the olden olden days was the upper acceptable limit for
serum bilirubin. 25 got replaced by 20 gradually, because people
started initiating measures to lower bilirubin as it *approached* the
*limit*. Twenty was 'well on the way to 25'. Then, 18 was 'almost 20'
and the merry-go-round could start spinning. Yikes.

I haven't read that study, but I can, and will, probably tomorrow at
work. Will be interested to see how many babies are in that one. I'm
guessing there are more, since it seems likely it was done on existing
data from patient records. Here is the reference:
Flaherman VJ, Rokser S, Tewman TB. First-day newborn weight loss
predictis in hospital weight nadir for breastfeeding infants.
Breastfeeding Medicine 2010;5(4) 165-168.

I want to reiterate that Valerie Flaherman is not an ignoramus about
nor enemy of breastfeeding. We all work within a context. Her context
is a US hospital and I don't mind admitting that we are just as
hyperanxious here in Norway. 'Well, the baby has already lost almost
9% of birthweight so just in case, told mother to feed three-hourly
and supplement with formula' even when the weight is from before
lactogenesis 2. Sigh.

It is outrageous that, as several people have mentioned, mothers are
provided with formula in set amounts suitable for two week old babies,
in BOTTLES. Sort of like giving someone in pain enough morphine for
three or four days because you don't have it packaged in small enough
ampules, and not informing them of how to dose it correctly.

Rachel Myr
Kristiansand, Norway

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