Debby Kearney wrote
>    In my private practice I see the majority of my clients after discharge.
>I seem to see more babies every day who are not latching prior to discharge
>and sent home with a pump and instruction on how to alternative feed
>(breastmilk by cup/syringe/fingerfeeding/etc.). I appreciate that these
>babies are not just given bottles and realize that hopefully some just
figure
>breastfeeding out and transition to breast without needing extra help.
>Likewise some will give up and move to bottles.
>    I have found that many of these clients that come to me are not using
>correct breastfeeding techniques!  By simply correcting positioning and
>attachment techniques, the majority of the babies do fine. A big concern is
>that many are told their baby is sucking incorrectly on day one- and think
it
>will never change!

Debby, I'm one of the nurses who work in hospitals with those babies who
won't suck. Believe me,  I try to make sure they are positioned properly and
that the moms know what to do to help them attach.  However, many of the
babies really do suck incorrectly, or they simply don't make any effort to
feed at all.  There's no question that those of you who see patients after
discharge truly are "inheriting" some problems related to poor (or no)
teaching in the hospital, but a good number of the babies I see have a suck
problem to begin with, and just teaching basic positioning and attachment
won't work for these kids, at least not in the first few days. I do think a
lot of suck problems are related to our obstetric practices, so I take every
opportunity to show fellow employees, residents, etc. the "Delivery
Self-Attachment" video--perhaps if all our babies were given a chance to
nurse without any separation (and if the epidural rate were somehow
miraculously to drop precipitously), we wouldn't have to send so many moms
home with pumps and droppers and cups and high anxiety about what should be a
happy learning experience.

Judy D in WV

PS  I tried your suggestion (I deleted the text of your response too quickly
so can't post it here) re nipple shields today with a 10 day old baby who was
nursing well at time of discharge, quit nursing when mom's milk came in, and
has refused to attach since then. Mom has been pumping (gets 6 ounces with a
Medela Mini-Electric pump in about 10 or 12 minutes!) and
finger-feeding---baby gained 7 ounces in the past 5 days and apparently can't
see any reason to resume a more strenuous program of actually suckling at the
breast.  I haven't used a shield in years and years, but what's to lose at
this point?  He didn't just go right to it, but mom is going to try the
shield at home (with all the pertinent warnings) and let me know if it works.