I see a fair number of babies each year for all sorts of reasons, and have
been counseling working women for over 20 years. The vast majority of these
women have had babies who, for one reason or another, have had bottles.
Once the babies are breastfeeding functionally, most adjust and can feed
both ways.
The dogma that suggests that "even one bottle" will compromise bfg is
inaccurate in my experience.
Further, it runs so counter to what so many mothers experience and can
plainly see for themselves that the statement compromises our professional
integrity.
NORMAL babies can make the switch easily. There are many factors that throw
newborns into the NOT NORMAL category (ususally temporarily). If a baby is
weak, ill, premature, injured, has
poor oro-facial tone, oral anomalies, etc. then the work of breastfeeding is
increased and normal feeding ability is impacted. The bottle looks
attractive to these weakly feeding babies because it eases their hunger.
Once they are well, bigger, stronger, adjusted, improved, etc. they can
breastfeed normally. So long as the mother has protected her milk supply so
that it competes effectively with the bottle's flow rate, babies are pretty
easy to transition back to breast. (Sometimes the intermediate step involves
using the right size nipple shield).
These older babies whose moms go back to work who then begin to have
problems with the breast may also be sliding over into a NOT NORMAL
category. Their issues may relate to nursing strike behavior in protest of
the separation. They may be reacting negatively to down-regulation of the
milk supply due to inadequate stimulation, fatigue and stress. Mom may be
so harried that her let-down is slow and baby begins biting and tugging to
super-stimulate the nerve to bring the milk down (as calves do when they
butt and tug). But I have many years of seeing mothers happily combine
breast and bottle feeding. Since all over the planet so many mothers must,
or feel they must, or want to return to their careers, our job as LCs is to
advocate for the right of the baby to continue to breastfeed. I see some of
the anti-bottle propaganda in the US as a not-so-subtle effort to control
behavior in favor of attachment parenting. (This is not a criticism of AP,
which I practiced myself when my kids were young. It is to say that my job
as an LC is not to promote my agenda, but to help the mother achieve HER
goals while trying to gently educate her about the needs of the baby.)
If we fail to understand what are the mechanisms of breast refusal, and
misinterpret them to mothers, we risk planting powerful suggestions that
work against mothers continuation of nursing. There are already so many
barriers, why add more? I tell everyone that of course they can combine
breast and bottle successfully if that is what they have decided to do.
Then my job is to make that happen if I can. What do you get if you fail?
The exact same outcome you would have gotten otherwise: mother weans so she
can use the bottle. What do you get if you succeed? Many more months of
human milk feeds for the baby and many more months of the kind of intimacy
that protects the bond of women and children who must experience routine
separation. I've never crunched these particular outcomes, but there are
few working women in my practice who wean prior to 12 months, including
mothers of twins.
Barbara Wilson-Clay, BS, IBCLC
Austin Lactation Associates
LactNews Press
www.lactnews.com
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