From: Reuters
Published April 17, 2008 01:24 PM

Traditional breast-feeding schedule best approach

By Joene Hendry

NEW YORK (Reuters Health) - Following a traditional breast-feeding schedule appears more beneficial for early infant weight gain and is more supportive of continued breast-feeding than a "baby-led" routine, UK researchers report.

The traditional recommendations have been largely replaced by "baby-led" breast-feeding which advises letting infants feed for an unlimited time from the first breast and that both breasts need not be used at each feeding, Dr. C. Anne Walshaw and colleagues note.

"Such advice is not backed up by evidence-based lactation physiology," Walshaw, of Bradford and Airedale Teaching Primary Care Trust, in Bradford, told Reuters Health.

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After noticing poor weight gain among breast-fed babies after baby-led breast-feeding became more common, Walshaw and colleagues compared early weight gain in infants who were exclusively breast fed. Thirty one healthy mother/baby pairs followed the baby-led advice and a similar group of 32 mother/baby pairs followed the traditional breast-feeding advice.

The traditional breast-feeding approach involves breast-feeding using both breasts at each feeding for no more than 10 minutes per breast.

They found that infants were more likely to be exclusively breast-fed for up to 12 weeks when their mothers followed traditional rather than baby-led breast-feeding practices.

Furthermore, feeding more than 10 minutes from the first breast was associated with poor weight gain during the first 6 to 8 weeks of exclusive breast-feeding, the researchers report in the Archives of Disease in Childhood.

Traditional methods take advantage of the physiological mechanisms of breast-feeding, Walshaw said. The regular, short-term use of both breasts at each feeding conditions the let-down reflex. Moreover, draining milk from both breasts at each feeding inhibits the slowing of milk production in an unused breast, and takes advantage of the higher fat and protein content of early-released milk from each breast.

By contrast, baby-led breast-feeding can decondition the let-down reflex through prolonged suckling at each feed, and can gradually enhance lesser milk production by using only one breast at each feeding.

Walshaw and colleagues conclude that strategies encouraging breast feeding must heed lactation physiology.

SOURCE: Archives of Disease in Childhood, April 2008

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