Feel like we slid two steps back.  I had a discussion today with one of our
neonatalogist who had read in the current issue of JHL that nipple confusion
does not exist and there is no rationale for cup feeding. We only had a few
minutes to glance at the article which was a study of 8 infants (from what we
could gather). He asked if we could provide him with any evidence that nipple
confusion does exist and the rationale for cup feeding to prevent it. I
called my husband who works at the medical school and he went to the library
for me and did a search ( what a great husband!!) and found about 4 articles
dating in the early 1990's, including one with some ultrasound pictures of
the merchanics of breastfeeding and bottle feeding. I haven't had a chance to
look over those articles. I also had my intern do a LactNet search and she
found about 168 posts with several references including the ones my husband
found. Does anyone have some words of wisdom about the JHL article?
Then I went into a room on the floor  and found out that a mom had been
advised to treat jaundice by "  breastfeeding for 10 min on one breast, 10
min on the other and then 10 min on a bottle". She didn't think that advice
sounded right so she called another Ped who told her to use a SNS and
supplement with 2 oz of formula at each feeding until her milk comes in".
Luckily she had some bfing information and together we came up with a bfing
friendly plan which including pumping and using that in the SNS ( to meet the
Ped criteria) but the baby only would take about 13 cc's in the supplementer
but nursed beautifully  and then had a saturating wet diaper. Hopefully a
poop was in the works for later. This baby did nurse for 30 min or so on one
side  but nursed in 5 min segments, then would take a break to study mom's
face then back to business.
So I guess we slide back several steps today!!
My one step forward was that I wrote and finished a grant to fund
breastfeeding discharge packs for 600 exclusively BF infants, which will
cover about 1/4 of our exclusively BFing mothers. I am submitting the grant
to 3 different foundations with the hopes of getting at least one. Another
step forward is that my intern compiled all our bfing data for 2001 and we
have data on exclusive bfing, bfing with supplements and total bfing ( both
of these). Our exclusive bfing rate is about 55%, and total bfing rate is
about 68%. We had big drops in February and Oct of last year. We're trying to
figure that out. When I worked at the Health Dept we noticed a drop in
breastfeeding in the winter but figured out that was prom and spring break
conceptions!

Barb Whitehead, BS, IBCLC
Eastern NC

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