Good Morning, Fiona,

I have a problem not allowing a premature infant to suck.  That is how
infants calm and relax themselves.  Ideally, the infant would be at mother's
breast.  If mother is not available, I think the infant should be given
something else to suck for comfort and organization whether it is pacifier or
appropriate, slow flow artificial teat.

We have fast flow teats in the NICU at the hospital where I work that seem to
stress some of the little ones.  I would prefer cup feed followed by pacifier
when mother is not available or bottle feed with slow nipple followed by
pacifier as needed.

It is true that there will be some nipple confusion.  That can be dealt with
later.  In our zeal to preserve the breastfeeding we must be careful not to
overlook the comfort of these very little folks.

I do not know whether being deprived of suck can cause an infant to forget
how.  Sucking seems so basic that I would be suspect of this and want to see
studies to document that result.  My concern is very different.

You may think that I am coming from an institutional practice that is
breastfeeding unfriendly.  The opposite is the case.   We have put an infant
less than 2 lbs. to breast and had him do quite well.  We have put infants to
breast with the oxygen tube hooked through mom's bra strap to hold it in
place at baby's face.  We tube feed at breast.  We offer d/c mom's a free
room in the hospital while the infant is in the NICU so they can be close and
feed.  We encourage KangarooCare.  It is not unusual for all of our NICU
babies to be receiving mother's milk.  The neonatologist tells parents who
are not planning to bf that they should still pump milk and send to
NICU--that he wants his NICU babies to have mother's milk.

Good Luck!

Pardee H. HInson, MPH, IBCLC
Charlotte, NC