Marilee wrote:

>One mother was told she had to start
>giving her baby a bottle or he would refuse to ever take one. She >started
>giving one bottle a day and gradually he started refusing the breast.

I have seen a fair number of babies who actually do refuse a bottle
altogether--will not take one from anybody, any time, any way.  It's easy to
say, "Well, smart baby!"  But for a mom who really does have to work, this
can be extremely upsetting, especially if the sitter is calling several times
a day to report that the baby is screaming and starving.  My colleague and I
usually suggest that moms who will be returning to work begin to use a breast
pump two or three times a week after the third or fourth week, so that baby
learns to take a bottle and mom is comfortable with the pump by the time she
resumes working.  However, I always add that, if the baby begins to have
difficulty taking the breast, mom should stop the bottles until breastfeeding
is again going well.

As for nipple confusion, I believe in it, too.  I've seen neonates who had
been feeding well, then were given a few bottles of formula, rooting
frantically at the breast but not attaching, as if they're looking for that
long rubber nipple.  I agree that some babies, maybe even most of them, will
switch back and forth pretty well, but they don't come with a label
identifying which is which, so I try to avoid nipples entirely for the first
few weeks, if at all possible.

Now, another question--what do you think about nipple shields?  Anybody out
there using them?  Are they anathema, or are they helpful in a few, carefully
selected cases?  We haven't been using them, but my colleague has suggested
we get a few and keep them under lock and key, so that the staff nurses don't
fall into the habit of solving every problem with a shield.  I'm willing to
reconsider, if anyone has had success with them.

Judy D