> " that bottle feeds with bili levels *greater than
> 10* did *not*, I repeat, *not* cause nipple preference. It was almost as
> if the sleepiness of the higher bili levels caused an amnesia of sorts
> regarding suck memory.
> >Just wondering, this is from your personal experience?  Not research based?
> >I would tend to think that you were the lucky one
Yes, it is from personal experience, not research based. Thank you for
asking for clarification.
It is based on 2 years fulltime experience for a Home Health Agency as
one of 3 pediatric RNs managing home phototherapy for normal mewborn
jaundice. We had a rather full practice with up to 3 or 4 babies each
"on service" at any given time. This represents something in the
neighborhood of 200 babies or so for me personally with this specific
diagnosis. The pediatricians we worked with were enlightened enough to
allow home phototherapy, but not enough regarding breastfeeding, and
wrote specific orders not allowing ANY breastmilk, not even EBM until
bili lights were discontinued (usually at a bili level of 10, and age
between 7-10 days old). I used to despair that any baby would return to
breastfeeding, yet I cannot recall any who did not; they all went back
to the breast. Part of our nursing care plan, however, was to provide
pumping support, so the milk supply was usually established by the time
the baby returned to the breast, and we nurses always planned a visit to
coincide with that very important first "reintroduction" to the breast.
Perhaps it was our teaching, support, and encouragement at that
feeding?! that made the difference. Also, during the days on no BF we
had discussed with the parents at length how the first few feedings were
going to be "teaching" feedings (mom teaching baby) about the breast
again, so the parents had an image in their minds of success. As I
recall, we encouraged mom to "anticipate" the feeding by 10 minutes or
so. Thus, the baby wasn't ravenously hungry and could pay better
attention, so to speak, at relearning the breastfeeding behaviors.
Critical factors in this are: 1)all these babies were fullterm and >5
pounds birthweight to be on service for home phototherapy, 2)all had
breastfed at birth and for 2-3 days prior to bottle feeds (extremely
important), 3)this was for diagnosis of normal neonatal jaundice, 4)all
babies had in-home follow-up and parents had support with 24-hr access
to an experienced RN if needed. This is a rather specific set of
circumstances, but it caused a paradigm shift in my thinking after
observing the first 40 babies or so; IMHO, an "amnesia" sets in which
also helps the baby return very easily to the breast.
It is one of the things about breastfeeding I would like to study, hence
my return to school to gain a research degree. :-) Hope this helps.
Katharine