I second Dee Kassing's words that cup feeding efficacy for preterm infants is
questionable.  I recall another master's student in Paula Meier's program
doing a small research project which weighed the "bib" before and after feedings
and the findings reflected lots of spilled milk on the "bibs" and lack of
adequate intake for the preterm infants.

However, research doesn't support any particular method of supplementation
for the preterm infant.  Whether supplementing with a cup/bottle/nasogastric
tube, all of the methods have risks involved.

If only more institutions would allow preterm infants to begin to suckle at
the breast at an earlier gestation than presently acceptable in many
institutions.  With test-weighing, volume of intake is measurable, and adequate
supplementing can be done.  But, for that matter, why don't I keep dreaming and we
could feed preterm babies according to infant cues rather than strictly by
scheduled feedings.

I understand that preterm infants exhibit subtle hunger cues, but at least
feeding in consideration with hunger cues rather than strictly by the clock
could impact earlier tolerance of breast feedings.  At the very least, NICUs
should not require preterm infants to take full feedings by bottle nor to take a
min. of 60 cc's every 4 hours by bottle prior to discharge.  They ought to be
kept on an every 2-3 hour feeding schedule.

Like Catherine Watson Genna stated, I love taking care of preterm infants and
being able to provide appropriate follow-up to facilitate their ability to
breastfeed.  And, like Catherine said, it is quite time-consuming to follow-up
with these clients.  They require a lot of emotional support as the emotional
roller coaster ride of ups and downs continue past discharge from the hospital
settings.

Carol Chamblin, RN, MS, IBCLC
Breast 'N Baby Lactation Services, Inc.
St. Charles, IL

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