Dear All:

Karleen's mention of addiction brought up the issue of our terminology. (No
offence intended Karleen - I enjoyed your post).

Yes, it is very easy to think of baby's with a weak suck as "lazy" or a
baby who won't switch over to breast alone after using the tube
as "addicted to the tube or after using the bottle as "addicted to the
bottle" or a baby who won't latch after a bottle as "nipple confused".

However, I don't think that these easy terms that we all fall into really
describe what is going on.  Babies are smart.  They want to eat and will
figure out a way to do it if they can.  I'm trying to think of different
terms and wondering if the rest of you have ideas.

Here's my thoughts:

"Nipple confused" and/or "Addicted to the breast, bottle, finger, etc"
really seems to be composing of one or more the following:

* tongue retraction
* tongue thrusting
* mouth insufficiently opened
* inadequate compression of the breast
* flow confusion
* stimuli confused (as in hardness, softness, compressibility of finger,
nipples, breast)

Help me out here - I'm finding those to be inelegant descriptions of my
observations.

I think "flow confused" can apply to the breast when we have women with
under or oversupply - or perhaps more appropriately fast or slow MER which
may or may not be related to supply.

I had an interesting case recently where the woman had low supply, but an
incredibly fast MER. The baby finished everything she had in 7 minutes
flat - and then there was nothing left.  He really needed more.

Best, Susan

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