In a message dated 7/19/99 1:39:43 PM Pacific Daylight Time,
[log in to unmask] writes:

<< Every case varies, and sometimes we, as lactation consultants,
 need to maintain a positive, yet flexible approach, especially when dealing
 with preemies and/or special needs infants.

 Anne Nans, RN
 Woodbridge, VA >>

thank you Anne
I have had too many phone calls from mothers feeling guilty and feeling that
they sould quit breastfeeding because their baby recieved a bottle. Many of
us are employed in systems that change occurs slowly. I work in a hosptal
that allows cup feeds for the term infants but it is not allowed in the NICU.
Yet, the NICU infants still end up on breast, it may take longer but it is
not impossible. When infants are seen as outpatients most often the issue is
not "confusion" but inneffective suckling-(I am even working with an infant
now that mom had no labor interventions and no bottles) or insufficient
milk-from less than adequate expression. In a perfect world it would be nice
for no infant to recieve a bottle, but that is not a reality. It is wonderful
is to hear about mothers of premies that exclusively went to breast, yet in
the NICU environment most of these moms live hours away (at least out here)
they are given options to stay at Ronald MaC. House other hotels, but they
are still not available
do to other social or emotional stressors. WE need to work on meesages to
mothers that are emporwering and supportive, we need to work towards keeping
mothers from feeling guilty because their infants have recieved bottles
(don't get me wrong I would love none) but I have heard from too many moms
thinking all is lost. Nipple confusion is too easy of a label.
The reality of working mothers keeps bottles in the day care setting a
reality. There are bottles that are slower flow and more favorable to
breastfeeding. I recently had a pilot that expressed breastmilk for over 1
year,  she was gone one time for 6 weeks and another time for 1 month, and
her baby breastfed when she came home.
Karen Querna

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