Betsy refers to moms who are fed up with finger-feeding or a
supplementer after a few days. She speaks of walking into the home
(as a visiting nurse) and the mother is not willing to use such
methods any longer. I also have had this happen many times, when I am
just seeing a mom for the first time at a week or more. I find that
this typically happens because the hospital instructions never
referred the mom to an LC and simply left her hanging with these
tools. When I ask what the protocol was for returning to breast or
when mom was instructed to re-evaluate the device, I am told that she
was just supposed to "keep trying" at the breast.
It is wonderful that hospital personnel are trying to avoid
immediately resorting to a bottle, but improper use of these tools
means that I am now left with fewer tools at my disposal with which
to help the mom. It is often the very early days when finger-feeding
can be most helpful, and when there is immediate follow-up into the
home, it can be a pretty rapid transition to breast for those babies
who just needed to organize their suckles, wake up a little bit or
get a jump start before mom's milk is in. I would really encourage
anyone working in a hospital setting where this happens often to
educate the staff in their proper use (primarily nurses, although I
have seen the same kind of advice from doc's offices where there is
no follow-up scheduled for a week or more). Every single day is so
important in the first week and moms can reach exhaustion very
quickly. A smooth flow of support can be so important to assuring the
successful use of interventions.
Jennifer Tow, IBCLC, CT, USA
> ------------------------------
>
> Date: Mon, 22 Jan 2007 06:43:32 -0500
> From: "Betsy Riedel,RNC,IBCLC" <[log in to unmask]>
> Subject: bottles and assessing sucking
>
> Sometimes, we have to resort to a bottle when baby is having
> ongoing issu=
> es=20
> and not getting adequate milk from the breast. As a nurse (and LC)
> who wo=
> rks=20
> in the hospital and often follows mothers and babies after they go
> home=20=
>
> (through the VNA), I find that when I am dealing with a couplet
> that has =
> more=20
> than thecommon couple of days worth of feeding issues initially, it
> is th=
> e=20
> parents who get sick anad tired of finger feeding or cup feeding.
> It is u=
> sually=20
> the mother who tells me (as I walk in the door) that she just
> cannot fing=
> er=20
> feed anymore and that she has put her milk in a bottle. Having to
> use the=
> =20
> suppplemental feeding system gets to be too much after a few days
> as well=
> .=20
> Alternative feeding methods are great as a short-term stop gap
> measure, b=
> ut=20
> sometimes problems drag on a lot longer than that.
>
> I know I have mentioned this before, but I would be interested in
> knowing=
> if=20
> any of you have tried the "Breastflow" nipple by First Years? I
> came upon=
> it=20
> totally by accident (a mother I was following went out and bought
> one) an=
> d I=20
> have to tell you, I was amazed at how different this nipple was in
> compar=
> ison=20
> to the others we all know. The baby has to use suction AND
> compression to=
> =20
> get the milk out and it come out very slowly as well. the mouth has
> to be=
> very=20
> wide open also.
>
> Personally, I'd rather see a mother who is happy giving her baby
> her milk=
> in a=20
> bottle while we as LC's are working on getting the baby to breast
> and mor=
> e=20
> important, protecting 9and increasing) her milk supply at the same
> time.
>
> Betsy Riedel RNC, IBCLC
>
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