Debbie writes:
Comments I have recently heard (around the NICU especially) have been
along the lines of "all alternative methods are equally as good or bad, so we
might as well use a bottle."
Even if this is true ( and I do think every assistive feeding device has
its advantages and disadvantages, and none are very much like actual
breastfeeding, though some can be used to bring out certain aspects, and all have
to be selected for each individual nursing dyad) it is not true that all
bottles are equally good or bad. The bottles that many hospitals get free
filled with AIM seem to be the absolute worst. They are pre filled with much
more than an average 0 to 3-4 day old baby needs, and their flow rates are
staggeringly ( or in this case, chokingly) rapid. I call them "speed
feeders", others call them "squash-and-floods". Either way baby often becomes
passive or reactive (tongue thrusting, biting, clamping, etc to try to
slow/control flow, which leads to tongue moves that will not work with
breastfeeding). Hospitals can try supplementing with tubes at breast, supplementing
with tubes off breast, cups, and slow flow artificial nipples with good
positioning, attempts to keep baby active in the feeding sequence, normal
volumes, etc. but all those factors are critical in the choice to use a bottle, in
my opinion. I'm not talking about casual bottle intro, I'm talking about
babies who cannot get enough to eat at breast in a reasonable amount of
time, sometimes even with a tube there to help them, without causing their
moms significant damage or unsustainable levels of stress.
My, uh, 25 cents>?
Peace,
Judy
Judy LeVan Fram, PT, IBCLC, LLLL
Brooklyn, NY, USA
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