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Lactation Information and Discussion <[log in to unmask]>
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Tue, 20 Jul 1999 17:25:09 EDT
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i am glad to see some good and thoughtful comments on this, and to read about
what is happening in various places. i have a couple of comments and
questions about some of the great information people have posted.

"In a perfect world it would be nice
for no infant to recieve a bottle, but that is not a reality" yes,  i agree,
and who would have thought that sweden and zimbabwe were the perfect world,
and NOT the good ole usa? could it be related to all the formula and bottle
manufacturers here? our not endorsing the who code? innate belief that bottle
feeding is normal? internalising bottlefeeding as normal? not believing it is
possible for preemies to breastfeed is a surefire way to keep them from
having a chance to do it.

" No country, including Sweden,
can match the birthweight-specific survival rates found in the US" nancy, i
am so pleased that you posted this, could you perhaps list the references for
this? my access to the medical library here is probably more limited than
yours, but i would like to put the study (or studies) on my list of things to
get copies of.

"While cup feeding works well for babies close to term, I think our neonatal
occupational therapist (NDT and SI certified) would drop dead if we tried to
transition premies  with a cup because it does nothing to teach correct jaw
and suckling action in preparation for breastfeeding."
i am so sorry, i just had to laugh about this, having just spent a couple of
days in a room full of OTs. they know so little about breastfeeding that it
is almost surreal. no, it IS surreal. just to quote dr. newman here "the only
way to learn breastfeeding is by breastfeeding." maybe the babies that are
born should all have little tests administered, and if they don't have
"correct jaw and suckling action in preparation for breastfeeding" then they
should be forbidden to feed with their mouths. until they have learned. who
has learned to ride a bicycle by riding a horse?

"I'm not necessarily in favor of fortifying breast milk if it is not
necessary, but I am definitely in favor of reducing any incidence of
nutritional deficiencies from whatever cause when it is possible"

if you have read carefully, you will notice i haven't said we should never
put anything in breastmilk ever, although i do maintain babies are doing fine
with breastmilk. if there is a need for extra calcium, extra vit. d, that is
supported by the literature, why should we object to using that for the
smallest preemies? what i object to is these things being packaged in cows
milk, which is given to just up the calories to achieve that mythic
intrauterine growth rate. i can buy powdered calcium in my grocery store, why
would i want to buy it in a milk powder from a formula company, as if that
were the only alternative? vit. d, doesn't that come by itself in a liquid
that is not milk?

i have been told my one of my clients that many mothers of preemies, now
several months old and out of the hospital and doing "fine," are adding
things like oil, butter, karo syrup, etc.,  to the babies' formula (also
concentrating the formula), in an effort to get them to "grow like they did
in the hospital." don't ever underestimate the power of example. i am not
sure anyone ever "gets over" the nicu experience (emotional, i mean).

and in response to a private post about using nuk nipples "because they are
the best for teaching babies to open their mouths so they can learn to
breastfeed, which is what the nurses and doctors and neonatologists here all
recommend," let me just point out that every month i go to lactation journal
club. like everywhere else, most of the people attending are nurse LCs. one
day a lovely discussion of what and how to supplement and when arose, and
would you believe it? every single hospital uses some nipple or other, but
NOT the same ones. and they all said that the one they used was chosen
"because it is the BEST one for teaching babies to breastfeed."
"its the only one our doctors will allow us to use." and what evidence are
these doctors using to make this determination? i bet it is . . . information
from formula companies. it must be, since so few of them go to the kind of
conferences all of us go to.

so how many of us think we could teach someone to have great sex by using a
plastic doll first until our subject showed the "proper technique" and could
thereby be
"allowed" to have sex with a real human?

as long as we think breastfeeding and breastmilk is expendable and not
something crucial to protect, we will have lots of discussions like this.
there was also a terrible scare about hiv in blood supplies, but we didn't
quit using human blood, we did the best possible (although too little too
late and too slow, for various reasons) to make sure the blood supply is
safe. of course it is not "perfect."  there is no safe substitute for human
blood. as long as we believe that formula is equal or superior to breastmilk,
breastfeeding and breast milk will be expendable in lots of situations.

carol brussel IBCLC
laura nevada lactation

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