The ongoing discussion of use of alternative feeding methods is an healthy
one IMHO. in many posts, however, I see the mother's concerns regarding use
of alternatives but no mention of the baby and what is in the best interest
of the baby therapeutically. We are lucky that we live in an age where we
have so many options, but our choice of which option to use must consider the
goal of getting the baby back to breast with as little intervention as
possible. For one baby, a bottle may be the right approach but for antoher,
finger-feeding may be the right approach. And, yes, what is acceptable to the
parents should be taken into consideration.

In the absence of research regarding alternative feeding methods, we have to
make decisions based on what we clinically observe to be productive. The
definition of productive will change for each LC because so much of what we
do is theoretical at this point.

i am disturbed by the lack of a solid theoretical and research-based
orientation of the discussion. i see much opinion, but it seems to be not
very well thought through. At least from the infant's perspective.

We know what constitutes proper sucking and milk transfer, We know what
constitutes proper infant organization. We know what factors influence a
woman's ability to commit and stick with breastfeeding. Why don;t we consider
what we know and put alternative feeding into that context.

As a lactation therapist, my goal is to get a baby to breast in as timely a
manner as possible with as little intervention as possible, and ensure that
the baby is going to be well organized and able to optimally trasnsfer milk.
I continue to guide therapy until that goal is achieved. In the process, i do
not want to stress out the family. It is within this framework that i make
decisions about what approach is going to work best, partnering with the
family in that decision-making process.

But sometimes, the use of a specific tool over another can't be left up to
the mother becuase a baby indicates with their behavior and feedback that the
tool of her choice is not the best one for him/her. It is then my job to
educate the motehr as to why a certain approach is optimal. i am far better
able to get most complex situations nicely resolved when working from this
philosophical construct: much more than ever before.

Off my soapbox now.

Alison K. HAzelbaker