Hi, All: I vividly remember a statement made by Kittie Franz 20 years ago
as she lectured to our UCLA Lactation Training Programs class that has
stuck with me all these years and has become my practice mantra:
What do I need to be doing to put this baby to the breast?
If we all lived by these words, many of the problems and attitudes that we
see in breastfeeding management would be greatly lessened or not even rear
their ugly heads. So...in terms of relactation, the easiest way to
accomplish this is to PUT THE BABY TO THE BREAST. If the baby will
willingly suckle at the breast, ALL the feedings can be done at the breast,
allowing for frequent practice. Some sort of feeding tube device will be
needed for a time, possibly the entire time the mother nurses this baby.
The preference is EBM, but if her life circumstances make pumping too much
of a stressor for her, I would rather see her expend her time/energies in
putting her baby to the breast instead of at a pump, and use formula in the
FTD. I have also used a combination nipple shield/feeding tube at the
breast to "fake out" a baby who is totally into bottle feedings. Whatever
it takes to PUT THE BABY TO THE BREAST, and whatever the mother is willing
to try is the method we use. I usually end up with a happy mother and
thriving baby and many of these couplets go on to exclusive nursing. Even
if mom ends up with a partial milk supply, she is still NURSING her baby.
And isn't it what this is all about - the TOTAL breastfeeding experience,
rather than getting stuck in the nutritional component of breastfeeding and
ignoring the emotional/bonding component. I would rather see a mom
partially breastFEED and nurse her baby long-term, than struggle to fully
breastFEED and end up nursing her baby for less time than she would have
liked due to the obstacles and barriers put in her way (breastfeeding
technology - the term coined in the new Breastfeeding Handbook for
Physicians - pumps, FTDs, galactogogues, etc.).
Pam Hirsch, RN,BSN,CLC
Clinical Lead, Lactation Services
Advocate Good Shepherd Hospital
Barrington, IL USA
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