Hi all,
In response to Nikki's post - re shield's vs.EBM + bottles.
Theoretically it would seem that even a large nipple shield would present a 
challenge to this baby,
but somehow, sometimes, shields just work. It isn't always cut and dried 
that it is indeed the large nipple that is preventing successful latch. I 
find that not everything works with every mom, and likewise with different 
solutions. I would also try a shield first, just in case it would work for 
whatever reason. Pumping and giving a bottle seem to be the last resort 
IMHO, because pumping in itself is daunting for a new mom, and we all know 
what can sometimes happen as a result of bottle use. The shield is still 
closer to nature than the bottle, as far as baby's activity at the breast, 
the amount taken in, and of course the rate of intake.
The shield, constant followup and weight checks to ensure sufficient intake 
and the baby's natural growth might very well take care of the problem. 
Somehow I also think that from the mom's perspective, this boosts her morale 
and confidence more than turning to pumping and the bottles.

Ellen Shein,
IBCLC LLLI
Tel Aviv - and for those of you who missed my weather reports - still sunny 
and gorgeous here in the Middle East!! 

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