In direct contrast to some of the recent stories we've shared, my cross to
bear this week is moms who "think" they are breastfeeding fine, have sore
nipples, hungry babies, and refuse to consider any interventions to improve the
situation or tell me they don't really need help. What can you say to that?  I've
recently started working at a hospital that did not have an LC or program for
more than 2 years. I walked into some odd practices; such as syringe feeding
as an alternative for moms who want baby fed in the nursery or wish to
supplement. The syringe is not used with a tube at the breast, not used as finger
feeding with a syringe and tube but "squirting the milk" into baby's mouth to
"avoid nipple confusion." (but they don't care if it is formula!) In my opinion,
this can be dangerous and does not teach baby about suckling.
       One of today's situations was a baby who was more than 24 hours old
and had only one small stool, going home and mom and dad did not want to pump,
supplement or get any help. She also had very sore nipples with abrasions on
the tips of both. I did manage to answer some of their questions, gain some
trust and get baby to breast with a better latch before mom went home. I told them
to call me if he had not stooled by 6 pm, (this was around noon) and when
they called he had NOT. They are admanant about no bottles or formula. I
suggested expressing colostrum into a spoon and feeding that, letting him suck on a
pinky finger before latching on (which worked pretty well when I helped them)
and they said they'd try - luckily they have a peds appt at 930 am tomorrow.
This one is scaring me.
       In terms of this syringe feeding practice, I am attempting to educate
about the mechanics of suck and swallow and hope that the staff and parents
will understand when given factual information. and evidence based practice. I
didn't really know the previous LC, she was very committed to breasteeding and
I'm not sure how this got out of control but I"ve got to find some good ways
to start....thanks for letting me vent and I look forward to any suggestions
for facilitating change.
Mary Kay Smith, RN, IBCLC
Canton MI

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