Jen
in responce to your post:

"One nurse told me that a patient, who is hand expressing her colostrum
for a baby who is refusing to nurse, and doing it more effectively than
with the pump, should pump anyways because the pump provides more
stimulation to build up her milk supply than emptying her breasts"

I can't say if a pump provides more stimulation, I can't see that it does but someone correct me if I'm wrong, the bottom line is to empty the breast to create more milk production.

"I have heard several
nurses say that they think a baby learns to suck better from a bottle than
with finger feeding, especially one with a NUK nipple.  "

They don't have any objective data on this do they? I await the opinion of others.
Is this were Jack says something like the only thing that teaches a baby to breastfed is breastfeeding?

"As an aside, cup feeding is banned from being used here as some
physicians feel the chance of aspiration is too great (arggh)."

There is a recent (within the past yr) article about the safety of this by Cindy Howard, MD in Pediatrics


"The hospital policies are all in place to make this a breastfeeding
friendly hospital but the staff do not follow them.  The manager is giving
lipservice to breastfeeding support and is doing as little as possible to
change the current situation as possible.  There is no one who follows up
to tell the staff when they are giving inappropriate care or information
but I was chastised for suggesting cupfeeding to a patient, even though it
was very successful in getting the baby onto the breast after classic
nipple confusion.  How do other hospitals go about following up with "old"
nurses who have no interest in learning anything new or in changing their
practises.  Policy has to become practise for it to work."

This sounds tough. My experience has been to get a few nurses in support of breastfeeding who do things correctly and encourage the other nurse and to also ally my fellow pediatricians to change routine orders and protocols so the mandate comes from above these "old" nurses.
I do it the friendly way when I can such as when a baby needed supplement I causally asked for a medicine cup, told the nurse we can cup feed the baby, I'll show mom how then I tell the nurse "walk this way" as I go toward the mom/baby's room. Of course I then walk like the character in the movie "Young Frankenstein" to give the message "yes, I'm crazy but we are going to cup feed this baby"

Is it just me or do babies cup feed better for mom? They make a little mess when I do it.

Rob    


Robert Cordes, DO, FAAP, FACOP
general pediatrician
Wilkes Barre PA
mailto:[log in to unmask]

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