I must input here as someone who was an OT in a NICU  for over 5 years
and as a LLLL for over a year now.
As in every field there are very knowlegable OTs (or LCs for that
matter) and there are some who aren't as knowledgeable.

There are instances when oral stim can make the difference in a premie or
full term baby who has sensory integration difficulties.  I believe the
breast is obviously the first  choice but sometimes lighter or deeper
touch is what a baby needs to understand what to do with the nipple in
the mouth. And "ideally" all babies should know how to suck but they
don't due to drugs, birth complications etc.
For those OT/SPs using a bottle, maybe it comes from a lack of
understanding of knowledge of breastfeeding.
I believe all OTs or SPs could benefit from some lactation knowledge from
LCs as I also believe some LCs could benefit from some knowlege from the
OTs they work with.  Each field brings a different perspective to a
situation.

 We all want to promote lactation and help babies get the best.  An OT
referral doesn't need to be used in every instance, but referring to a
good source can be invaluable.

Jill Andrews OTR, CHT,LLLL
mother to 4y/o daughter and 18m/o son
Dh who is a mechanical engineer who "knows" the answers to most basic bf
problems.

PS. the EBM of the cotton swab is so the stim is a more positive
experience.

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