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From:   glblank[SMTP:[log in to unmask]]
Sent:   Friday, May 16, 1997 2:19 PM
To:     Glenn Evans
Subject:        Re: goeff's cupfeeding questions

Glenn Evans wrote:
> 
> I may have no case studies.  But I have worked in a hospital in L&D and postpartum for 21 years.  I have been cupfeeding infants  for longer 
than that, startin
> 
> If I can't prove the long-term aspiration effects of breast vs. bottle  vs. cup, neither can you. 

The research that does exist relates to long term effects of silent 
aspiration in adolescent, chronic silent aspirators who presented with 
varying histories of cardiorespiratory problems.  One issue raised was 
what came first, "the chicken or the egg" - chronic silent aspiration or 
chronic CP issues.  Other studies suggests that EBM is "clear fluid" 
which if so reduces risk and that natural immune factors are present.  
However if you leave a bottle of EBM in a 98.5 environment, does it not 
colonize?  And regardless of rate and breadth of this phenomena, 
pulmonologists rarely even allow distilled water when the risk of 
pernicious silent aspiration is present and what liquid could be more 
"clear"?  So what you are advocating is, Well let's try it and see what 
happens.  I wonder what would have happened had Einstein or Oppenheimer 
said, "Gee, Let's just split this atom and see what happens?"
> 
>  I think most of the literature related to aspiration, that you are reading, has to come from babies who were bottlefed formula, since that 
is how the majority

Recheck your resources, you'll find that to be inaccurate.

> Recent research in   breastfeeding has taught us more and more about what babies are able to do. We've seen that younger and younger 
premature babies can breas

Opps! What happened here? 

> You mentioned in one of your posts the studies on the necrosis "discovered" on autopsy.  Does this mean the infants demised for other 
reasons than the aspirati

You need to adjust your word wrap, most of yuor message is being 
deleted.  The necrotic tissue was from pernicious silent aspiration. 

> A thought that has crossed my mind several times since you started
> asking questions.  Could it be that the newer born an infant is, the easier it
>  is to learn to cup feed, because he still hasn't really mobilized all his
> feeding responses, and so more readily adapts to whatever system is
> being used?  I have seen very voracious breastfeeders who had no use
> for a cup, and didn't want to learn without good reason.  Infant motor ability has been fully documented and restudied to 
infinity.  Flexor physiology is suckle physiology.  When infants suckle 
the nipple is drawn fully to the oropharynx.  The oral phase is rendered 
moot with the exception of expressing the milk.  Cup feeding engages the 
oral cavity for processing the milk to be swallowed.  The undulation of 
the tongue required to safely process liquid to the pharynx is not 
developed pre 4 mo., it is after ATNR and extensor development is this 
seen.  Milk is not lapped when drawn from a cup.  I have seen numerous 
posts from LLL members who state the same.  It is drawn in by negative 
pressure created by tongue pumping such as a piston draws air and gas. 
Liquid bolus is not controlled in the transition between oral phase to 
pharyngeal phase of swallow (ever seen a video swallow on an infant?, I 
assure that this last statement to be true - me and a few researchers

Alternatively, I
> have seen infants unable to latch, with a disorganized bottle  suck, who
> took to cups instantly.

Does not prove a thing when it comes to safe swallow. 

> I  have to ask.  How many babies have you SEEN breast/bottle 

13 years exp. feeding swallowing, 80 hours CE numerous video studies I 
can't count.

> cupfeeding?    

None.

> This is not meant as a put-down.  But once you have seen
> a newborn cupfeeding, you can no longer say they aren't capable of
> doing that at less than 4 months.  

Read my posts again, I don't believe I said *aren't capable*  If I did, 
I retract it.

> I am glad you are asking questions and willing to learn from our collective
> expertise of both BF literature and experience.  But why are you so
> combative in your questions?  

Quite frankly my only *negative* reply was from you.

It seems as if you feel a threat, either
> personal or professional, from the fact that babies can cupfeed. The
> scientific method is to form a theory, then design experiments that
> prove it.   There are a lot of experiments that yield results different than the
>  ones expected.   

I feel stongly about posing a risk to those I manage when a small 
segment adamantly insist cup feeding works when they miss one all 
important health risk - aspiration.  

> Often because of  variables included or not.  But
> sometimes the basic premise is wrong.

Back atcha!

> A cartoon in my mind's eye:  Einstein scratching his head looking at a
> mom cupfeeding her newborn, and saying :
>                    "Vell, I see ve vere wronk.  Zey ken do zat!"

 A man comes upon a thousand dollars. He wants to surprise his wife with 
the money, so he goes to the river, splits the money into ten jars and 
floats them downstream.  Problem is the river divides before it gets to 
his house.  How many jars does he average if he were to repeat this 
process 10 times?

Not to be picky but it is Geoff - as in Chaucer.
> So now Goeff, the ball is back in your court.  Serve!

Service ace, 15-love. Or something to that effect.

Geoff