Rachael:
In my experience, the problem with that type of suit would be how to prove that
the problem the baby is having is directly related to the bottles the baby has
been given. Just this week I had a set of twins - both have received one bottle
of glucose.  One is breastfeeding wonderfully, the other is "Nipple confused" -
the definition I use is how the tongue feels when I do a suck check.  When I get
the pressure at the tip of my finger, I call it nipple confusion.  [Perhaps we
need to go into how to diagnose the types of incorrect sucking of the mouth and
tongue.]

However, I have had occasion to do suck checks of babies immediately after
delivery - as part of the normal nursing (RN) physical - and have felt that same
type of pressure from babies who have been sucking their fingers or their tongue
in utero.  [They are very difficult to work with those first few days,
especially in my current situation, due to overmedication of mom and baby,
separation after delivery, planned inductions, etc.  Then of course I only have
them in the hospital 24 - 72 hours.  But that is another story.]  How do we
prove the problem was caused by a bottle nipple and not for other reasons.

I am concerned about unnecessary bottles and wish we could figure out a way to
prevent them - having worked in a hospital here for almost a year trying to
change their ways - we need to realize that to many nurses bottle feeding is
what they know.  When a baby is unusual (which in Puerto Rico is the norm), they
respond with their usual: 1) Make sure the baby can suck  2) We can't let it
starve until it learns how to nurse!  They are not trying to be hurtful, and in
order to teach change we need to have them feel we are on *their* side,
understand they are doing the best they can with their current knowledge, and
teach by example.  We can't replace all nurses with people who believe we do -
so we need to realize that *conversion* takes time. Not all will go along, but
if enough do, and the norm is *avoiding* bottles, there will be fewer given
-which is our ultimate goal, not punishment or firings.

At the same time, the parents need to be reinforced in their power to advocate
for their babies and insist on early and frequent nursings and taught where to
get support in case it is not forthcoming in the hospital.

Jeanette Panchula, BSW, RN, IBCLC - Puerto Rico
[log in to unmask]