Hello,

Like Norma Ritter and others, I too have been enjoying the discussion of
the diagnosis, prevention, solution of nipple/suck confusion.

I am relieved by many comments that seem to say that a return to total
breastfeeding can not be predicted and there seem to be no real signs as to
when that will happen. Also it seems that people are saying that a
return is encouraged by not one specific technique, but the trying
of many till the one is found that works for that baby. I think this takes
pressure off of us to find exactly the information, technique that will
work with a mother's child the first time around.

I am seeing myself and hearing from you that the mother DOES need to
be committed to really working at getting a return. There are no magic
tricks. A mother who has patience for only a day or two often apparently
will not succeed. It is unfortunate, since the enjoyment of breastfeeding
can be of a length so much greater than the time that it takes to get a
child back on to breast.

I have a few recent experiences with finger feed. Thought to share two of
them.

A mother came by my home a few weeks ago.  After receiving permission to
check her 6 week old baby's suck, I found a child that did not suck at all
on my finger, despite all stimulation that I gave the child's palette. I
had a few sterile, still in their packages, feed tubes and syringes left
over from my daughter's hospitalization this winter. I rigged them up and
put the baby's formula in the syringe. Within two seconds of tasting the
milk that dripped off my finger in the baby's mouth, the baby started to
try to suck. Slight pressure on the bunched up tongue caused immediate
relaxation and the baby correctly pulled the finger together with the tube
back into his month and began a very delightful session of finger feed. The
mother successfully then finger fed after observing me. I explained from
where one can go from this to the mother, in a fashion very similar to
Norma Ritter's recent explanation. By the baby's very quick response to
correcting of what he was doing with his tongue, I had very positive
feeling about getting this baby on to breast. However, the mother, despite
her enthusiasm, considered the time it would take and decided that it was
not worth it to her. She would be returning in 6 weeks to full time
university study and she wanted to enjoy the time and not be on an
emotional roller coaster of hopes. She did not mind expressing her milk and
bottle feeding him till then and then gradually transferring all his feeds
to ABM.

With this baby, I tried cup feeding and it did not go over well. Spoon
feeding did go well and easily.

This child was being bottle fed his mother's milk because the hospital had
said the baby, born at approximately 5 pounds, was too weak to suck from
the breast and for the first 6 weeks he should bottle feed. The mother came
to me when he was 6 weeks asking how she could now get him on his breast.
He had latched on slightly for a few minutes the day before and she wanted
to know what she could do to encourage him.

Another experience that I had was with my own daughter 6 months ago. She
was born at about 3 pounds, 1485 grams, at the end of the 36 week, severe
IUGR. She was on IV for two days, then tube fed my milk for two weeks, and
then bottle fed at night by the nurses, and finger fed and cup fed by me
during the day feeds for about 1 week. The nurses did about 3 feeds and I
did 5 feeds. My feeling was that the finger feed met her sucking needs and
gave me a way to get the milk into her when she was too exhausted to suck.
I felt it got her ready for when the doctors felt that she was strong
enough to nurse. The doctors would not let me put her on my breast, even
with a tube taped to my breast dripping my milk into her mouth. I do have
to add, that had she been on my breast there would have been no way for me
to keep the breast in month, when she lost energy. When she was too tired
to suck, usually half way through her feed of 40cc, I would squeeze a bit
of the milk into her mouth and wait for her to swallow. Cup feeding at that
point would not have worked because of her exhaustion. I was able w/finger
feeding get the rest of what she needed without switching to another
technique half way through a feed.

Towards the end of that third week, when
she started to root, I started to nurse her. She latch on like a barracuda
and nurse much more than the doctor wanted. The first time that there was
no time constriction, she nurse 50 minutes. On the fifth day of nursing
her, we jumped from 2 nursing feeds a day to only nursing. The doctors sent
me home that day feeling I would be more relaxed there and not have to put
up with the hospital routine. They encouraged me to nurse no fewer than 8
times a day and they ordered me to wake her up during the night if she
slept longer than three hours. The first day that she nursed only, she was
wiped out. I had to wake her many times to nurse. By the third day of
nursing, she was nursing like a pro. By chance, during a return visit to
the hospital to check on her weight gain, the doctors and I learned that
she gained in one five minute feed 45 grms.

I found that the finger feed gave me skin to skin contact like nursing and
allowed in a sense to feel like I was nursing at a time when I couldn't.
Cup feeding was very easy and took less time than the nurses' efforts to
get a bottle into the baby. Finger feeding took me 40 minutes to over an
hour.

I was not in a baby friendly hospital, however, I was in one where the
doctors were willing to discuss all options and have me try them out. The
rule was that when the nurses fed my daughter they would do it the way they
wanted. I was allowed to come for as many feed that I could. After a CS, I
could only manage 5 out of 8 feeds.

Anyway, I have been hearing a lot of pros and cons with every technique,
but I think what I am hearing is that each case is individual and we need
to find what works with that child. Persistence, time, love, and patiences
seem to be very important elements in a return to total breastfeeding.

Devorah from sunny Israel.