Debbie writes:

Comments  I have recently heard (around the NICU especially) have been 
along the lines  of "all alternative methods are equally as good or bad, so we 
might as well  use a bottle."  



Even if this is true ( and I do think every assistive feeding device has  
its advantages and disadvantages, and none are very much like actual  
breastfeeding, though some can be used to bring out certain aspects, and  all have 
to be selected for each individual nursing dyad) it is  not true  that all 
bottles are equally good or bad. The bottles that many hospitals get  free 
filled with AIM seem to be the absolute worst. They are pre filled with  much 
more than an average 0 to 3-4 day old baby needs, and their flow rates are  
staggeringly ( or in this case, chokingly) rapid. I call them "speed 
feeders",  others call them "squash-and-floods". Either way baby often becomes 
passive or  reactive (tongue thrusting, biting, clamping, etc to try to 
slow/control flow,  which leads to tongue moves that will not work with 
breastfeeding). Hospitals  can try supplementing with tubes at breast, supplementing 
with tubes off breast,  cups, and slow flow artificial nipples with good 
positioning, attempts to keep  baby active in the feeding sequence, normal 
volumes, etc. but all those factors  are critical in the choice to use a bottle, in 
my opinion. I'm not talking about  casual bottle intro, I'm talking about 
babies who cannot get enough to eat at  breast in a reasonable amount of 
time,  sometimes even with a tube there to  help them,  without causing their 
moms significant damage or unsustainable  levels of stress. 
 
My, uh, 25 cents>?
Peace,
Judy  

Judy LeVan  Fram, PT, IBCLC, LLLL
Brooklyn, NY,  USA

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