Dear Friends:
    The last time I checked, Medela had no safety and  efficacy studies to
support the use of the Hazelbaker fingerfeeder.
    While there appear to be a variety of reasons for  using finger feeding,
where are the published studies that show that finger  feeding helps babies to
breastfeed?
    Not all bottle nipples collapse, especially when  they are brand new.
    How many LCs are academically trained in OT/SLP  assessment and
techniques of tongue exercises? If babies are having airway  protection problems, LCs
are not the ones to be diagnosing and treating such,  although we are certainly
part of the health care team.
    According to Wolf and Glass, babies with tongue tip  elevation (commonly
premature infants), elevate their tongue tip as a means of  stabilization when
there is decreased tone and stability in the head, neck and  trunk. They
recommend providing postural support (1992 edition, p. 237). They  suggest "quick
swiping or vibration to the tongue tip, followed by downward  pressure into
the tongue."
    While many LCs with years of clinical practice have  developed a working
knowledge and expertise, one concern I have is about LC  students. One I
worked with was ready to endorse finger feeding based on what  she had heard and
the marketing of finger feeders on company websites. She was  surprised when she
did a literature search and found nothing to support finger  feeding, despite
some strong opinions from experts in the field.
    Finger feeding might be a fabulous tool. Talking  about it on LACTNET is
interesting; training new LCs in its use is at present a  hit or miss event.
    Perhaps those of us with expertise, as so  thoroughly described in a
previous post, would please publish a collection of  case histories which would
start the ball rolling for some scientific  support?
    I am thinking of another situation where common  knowledge and written
material were proved wrong after research. We have all  seen the literature that
talks about Hoffman exercises and breast shells to  treat inverted nipples in
pregnancy. When the Alexander study was done, and  the results were
replicated in the MAIN Collaborative Trial, the results were  amazing. The mothers that
were in the control group (neither shells nor  exercises) had the most
successful breastfeeding. Neither shells nor  exercises did anything to improve
nipple protactility.
    warmly,
Nikki Lee RN, MS, Mother of 2, IBCLC, CCE
Maternal-Child Adjunct  Faculty Union Institute and University
Film Reviews Editor, Journal of Human  Lactation
Support the WHO Code and the Mother-Friendly Childbirth  Initiative

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