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July 1979

Breast-feeding and Malnutrition-Reply

Author Affiliations

759 Chestnut St Springfield, MA 01107

Am J Dis Child. 1979;133(7):757. doi:10.1001/archpedi.1979.02130070092028

In Reply.—The diversity of verbal and written responses (and abuse) we have received concerning our case reports of critically malnourished breast-fed babies (Am J Dis Child 132:885-887, 1978) is well illustrated by the letters from Jacobs, Waletzky and Martin, Kutnik, and Labbock. The comments of many pediatricians appear to support the contention that inadequate weight gain by breast-feeding babies is more common than is generally recognized. At the same time—and this we also wished to emphasize—successful breast-feeding requires careful instruction and support by medical and paramedical personnel, and early follow-up for primiparous mothers is particularly important. The point of our article was that parents, nurses, and physicians should not be lulled into assuming that simply because a baby is breast-feeding, he or she is receiving sufficient nourishment.

We are not sure why the babies reported in our series failed to receive enough breast milk. We doubt that the small