Kathy says,


> Actually,  bottle fed babies ARE assessed on their sucking and swallowing on
> the bottle. When a baby is a "poor" bottle feeder, he takes a long time to
> get a small amount down, often gagging or choking along the way. Babies are
> expected to actively participate on the bottle feeding and to consume the
> formula in a timely manner. We look for how fast or slow the feeding went,
> good sucking or poor sucking, gagging, or spitting up afterwards, and the
> amount consumed.
>

Of course I know they are assessed -- that wasn't my question.  My point was
that when you are teaching a mother about feeding her baby if she is bottle
feeding, you don't tell her that the baby has to eat for a certain number of
minutes or it isn't a good feeding.  (I'm discussing normal, healthy babies
here).  You tell her to feed the baby until he indicates satiety, whether
that is 7 minutes or 10 minutes or 15 or 20.  You may even tell her about how
much you would expect the baby to take, but you tell her in ounces or mls,
not minutes.  (And I realize minutes are limited w/ preterm infants -- not
talking about that).  And MY point is that with breastfeeding, you watch the
baby -- if he isn't drinking, you use breast compression, adjust the latch,
whatever -- but there is no research that says that if he's "breastfed well"
(whatever that means unless there is a written definition) for 10 minutes,
that he has breastfed BETTER than if he breastfed for 7 minutes, or LESS WELL
than if he has breastfed for 15 minutes.  Nor is there anything that
indicates that a baby takes 1 ounce every 5 minutes, or 1/2 ounce in 5
minutes or something like that.  Too many variables.  And one of the reasons
I really wish that we could get away from the clock.

This really hit home to me when a mom came to see me because her baby was
breastfeeding poorly, and she was concerned about it.  Baby gulped &
swallowed, and came off the breast, totally satiated at about 6 or 7 minutes
having consumed whatever was the appropriate amount for him (don't remember
now).  Mom was concerned because someone had told her he needed to breastfeed
for at least 10 minutes on each side, and her baby wasn't following orders.
So here's a mom needlessly worried because her baby is doing just fine --
just not what he was told to do.

And of course there are moms who are feeding for 20 minutes on each side and
thinking baby is doing fine because he's at the br for the appropriate number
of minutes, but he isn't EATING.  He's hanging out.  So I think we muddy the
waters when we focus on time and not the baby.

Jan B. in Wheaton

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