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EZZO-FIED!
by Katie Allison Granju<

Cue Feeding: Wisdom and Science

It is now commonly accepted that infants, most especially breastfed infants, thrive best when allowed to feed as they indicate their needs. Nevertheless, some mothers continue to believe that they must wait for their breasts to "fill up" between feedings in order to have enough milk for their babies, and some popular sources of advice for parents urge mothers to stick to a feeding schedule in which even young infants are fed at 3- to 4-hour intervals. Some infants may be able to thrive on scheduled feedings, but many others do not. Recent research on the breast's mechanisms for regulating milk production provides a better understanding of the importance of demand feeding and the role of infant appetite in the regulation of milk production.

......., Hartmann has concluded that the rate of milk synthesis between feedings varies according to the degree of fullness of the breast; the fuller the breast, the slower the milk production rate, and conversely, the emptier the breast, the faster the rate at which the milk is replaced.

...... It was also noted that the women who had larger storage capacities often nursed at longer intervals, whereas women with smaller storage capacities nursed at more frequent intervals. Breast size was not always a good predictor of production or storage capacity, and all of the women had the ability to produce plenty of milk over 24 hours. What varied was the amount of milk that could be delivered at one feeding.

......Supporters of schedule/routine feedings believe that longer intervals make for hungrier babies who will demand more aggressively and who will obtain the higher fat milk available at the end of a feeding. However, Woolridge has shown that prefeed fat levels are inversely related to the length of the interfeed interval. Fat concentrations of milk can be maximized by increasing both feed frequency and the amount of milk removed from the breast at a feeding. When feed frequency and duration are restricted by predetermined feeding schedules, the result may well be lowered infant fat intake, symptoms of breast milk insufficiency, and underfeeding.^2,10

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