Sorry to keep on about this, but I still don't see the advantage in
giving bottles to prems establishing breastfeeding. Why make this so
complicated?
What is the point in them learning one method then another? Can't they
just learn to breastfeed? Also, we know that oxygen levels are worse
while bottle feeding, the baby's body is telling us something -
breastfeed!

I am sure UK babies are not clever than US ones, but where I work, we
offer the breast when we see the cues. This is often at 31 or 32 weeks.
They latch on well, without nipple shields, feed with a good rhythm, do
not aspirate. At these early gestations we top-up with a naso-gastric
tube. We use intelligent guess work, nothing fancy like test-weighing.
As the baby gets stronger we reduce the top-ups, again using common
sense after watching the baby feed.
Most of them go home breastfed, always exclusively, not topping-up. We
consider that we have failed the mother/baby dyad if exclusive
breastfeeding is not established by the time the baby is ready for
discharge.

I think we are in danger of making all this too scientific,
breastfeeding is natural, simple, and it works - even for prems.

Regards,
--
Carolyn Westcott RN IBCLC Southampton UK
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