Hi Esther,
It's Martha! How are you? Where are you working? Great to see your post on Lactnet.
Here at my mid size level III hospital, we offer FF as one of several alternative feeding methods for babies who need supplementation. Staff nurses can and do initiate FF. Training is informal, nurse-to-nurse, or LC- to- nurse. We strongly encourage pumping by the mom of any breastfed baby who is being supplemented by any method, for stimulation, and to replace the formula with mom's own milk ASAP.
We have 2 IBCLCs staffed (one for NICU. one for MBU) every day of the week during day shift, so there is excellent followup on any feeding intervention. If there is ANY doubt abt the need for supp. on night shift, we have got the night shift staff pretty much trained to defer this decision until day shift, so the ped and LC can look at things.
My opinion of FF based on over 10 years clinical experience is that I think it can be a good thing for the baby whose mouth is disorganized, and needs to learn how to suck. But I don't generally recommend it for more than 1-2 days, for a number of reasons.
1. habituates the baby to suck on something that is a different diameter, length, and consistency than mom's breast;
2. all FF systems are more work and trouble to use and clean than a good, slow-flow bottle (i.e., Avent --in which I have no commercial interest) so you are adding to potential parental lactation burnout;
3. Flow preference: most FF systems flow faster than either the breast or a "good" bottle nipple, so babies get accustomed to an easy reward.
When I first started here, one of the peds asked me whether FF would cause "nipple confusion" , and I had to say I did not know. I did a literature search, and came up with nothing. does anyone on the list know of any research on FF? I did have one case of a baby who refused the breast after sucking on the pediatrician's finger during bedside teaching for about 15 minutes (not feeding, just pacifying): we got her back to breast with a nipple shield. Any other case reports of breast refusal after FF?
See you-
Martha Johnson RN IBCLC
Eugene OR
-----Original Message-----
From: Esther Friedman [mailto:[log in to unmask]]
Sent: Saturday, January 03, 2004 8:28 PM
Subject: finger feeding again :-)
OK, this is directed primarily to the MD's on the list. We have a situation in which floor nurses not trained in the technique are using finger feeds without LC direction or follow up. MY question (thanks to those who have already responded to the first post; very useful!!!): Is there a competency validation you use and or a protocol for use of fingerfeeding in your hospital? What feedback can you give on the situation we are facing here? What reccommendations would you make in terms of staff training requirements, follow up requirements, and other interventions to be used (pumping, etc)?? What percentage of your supplementation / alternative feeding methods are finger feeding? What is the average duration and follow up for these dyads? Thanks VERY much for any responses!!!!!!!
Esther Friedman, IBCLC, RLC, not a big fan of finger feeding ;-)
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