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Subject:
From:
"Joanna Koch, Ibclc" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 21 Dec 1996 15:37:42 -0500
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Yes!  Am not feeling very brave this a.m. so am responding to you privately.
 I have over the years tried cups, finger-feeding as alternatives to the
nasty bottle.  After ten years I have turned back around completely and am
now recommending bottles (as you say -- properly used) and save
finger-feeding as a very temporary method deliberately aimed at correcting an
issue.  Also, per Newman, I encourage use of finger to organize a baby before
offering breast.

I agree wholeheartedly that a mom needs to be enjoying the baby in those
precious early days and we must bear this is in mind when suggesting options.


I have had excellent, excellent results by using a nipple shield to get
things started (where there is a breast refusal).  Used them for years before
it was politically correct just because it was so nice to see the mom
teary-eyed with pleasure at finally having baby at breast (vs leaving her
with pump and "keep trying" advice).

Have been delighted with results of bottle-feeding to supplement or to bring
a grossly underfed baby up to par and then transferring back to breast.  But,
as Newman says, if mom's milk supply does not respond to proper management
there may always be some difficulty.

In my experience, all things being equal (i.e. good supply and good latch)
healthy, term babies will be delighted to take bottle or breast.  By and
large they will prefer the breast given a chance.   Have had several babies
recently refusing a bottle and continuing to suck away at empty breasts --
grossly malnourished though they be.

In my practice I prioritize the mom's sanity and the quality of her
interaction with the baby.  I would rather see her smiling with pleasure as
she bottle-feeds her expressed milk (hopefully temporarily as we get the rest
going) than crying as she and her baby struggle together.  I always work to
maximize breastmilk.

Heard a new term recently -- "breastfeeding gorilla" -- referring to those
LCs who insist on one way of approaching the breast.  Includes the attitude
that bottles are always bad and formula is always toxic.  Includes combining
parenting choices with breastfeeding such as the family bed and attachment
parenting.

Best advice I ever received re this job is to "meet the mother where she is".
 When I meet a home birth mom, with dad giving her a shoulder rub and plans
to be at home indefinitely you can bet I'll be talking family bed etc.  Cups
no problem.  Formula absolutely last resort to avoid malnutrition.  However,
usually this is not at all the mom I meet.

So delighted to read your posting...
Joanna Koch IBCLC in Los Altos, CA

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