----- Original Message -----
From: Automatic digest processor <[log in to unmask]>
To: Recipients of LACTNET digests <[log in to unmask]>
Sent: Monday, March 08, 2004 9:35 AM
Subject: LACTNET Digest - 7 Mar 2004 to 8 Mar 2004 - Special issue
(#2004-381)

In regards to Pat's post about the 37 weeker who is well below birth weight
at 2 weeks,  I agree with Karen Gromada's post
about  poorly feeding babies. I, also work with multiples, preterm, and
almost full terms. Ineffective BF is often part of general feeding problems.
A poor breastfeeder is often a poor bottle feeder. I point this out with my
couples so they can understand that is is not necessarily something that
they are doing wrong re breastfeeding. It is the baby's ability to feed in
general that is the problem. This helps mothers understand the concept of
giving the baby some time and not feeling guilty about it. Karen's 2 rules
are essential. 1.Feed the baby. 2.Move the milk. This will probably involve
pumping when dealing with a  poorly feeding baby. Finger feeding may be
helpful for some situations, but is often overwhelming for the already
overwhelmed mom. I, like Karen, visit mothers who are ready to give up
because they think that, (1)If the baby is not fully BF soon after birth, he
will not be able to, so they feel very pressured. (2) If a baby gets any
bottles while working to get them to the breast, the baby's chances are
"ruined" to BF.(3) Pumping will not be able to sustain or build a supply.
We must look at getting calories to a baby in the most efficient and safe
way we can. Dee Kassing's bottle feeding article points out how bottles can
be a boost to breastfeeding when the baby is still learning how to transfer
milk at the breast. When the mother has twins, sensitivity to time
management has to be considered. Keeping 1 or more poorly feeding bab'es at
the breast for extensive lengths of time in an effort to get them fed or
increase milk supply does not work. Keeping baby's caloric intake up,
protecting supply, and working on latch  in a nonstressful atmosphere does.
Ann Anderson, RN,IBCLC,NJ

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