This is a post I put on over the weekend but sent it by mistake to
Linda Smith, who is the address beside Lactnet on my address book.  It
was in reference to Barbara Wilson-Clay's post about premature babies.
Sorry Linda.

Well, I must disagree with a lot of this post.  I would like to see
the data that bottles are safe.  Where is it?  Those of us that worked
in NICU's know that babies can and do aspirate when they drink from
the bottle--both healthy prematures and full term babies have
aspirated from a bottle.

In my opinion, the issue of nipple confusion is not one that has been
settled.  When the mother has an abundant milk supply, most babies
will do both, but there is still such a thing as nipple confusion, and
a baby who has received only bottles for the first few weeks of his
life is unlikely to take the breast even when the mother has an
abundant milk supply.  And we do not know which baby will be more
affected by the early use of bottles.  Why wouldn't those twins have
done well?  Because some don't, and we know they don't.

What we do between "lactation experts" is one thing.  But if we
blatantly state there is no such thing as nipple confusion or that
there is no harm in giving bottles, as many lactation experts assert,
we arm those who think we are completely off the wall with powerful
ammunition.  There are several pediatricians here in Toronto who have
"latched on" to Chloe Fischer's insistance that there is no such thing
as nipple confusion and are now insisting that a baby who needs
supplementation in hospital must be bottle fed for the supplement.
The problem is that they do not go to the lengths Barbara Wilson-Clay
or Chloe Fischer will go to help the mothers with breastfeeding.  On
the contrary, this information is then used to undermine all the other
things we generally think are important--close contact, frequent
feedings, good latching on, because, after all, bottles do not
interfere.  The corrolory is that either breastfeeding works or it
doesn't.  This is exactly what the attitude is.  I have seen this in
practice and the results are appalling.  The only thing I have to say
further, is that the more experience we have, the less we need bottles
or pacifiers.  Since there are alternatives to bottles, lets use them,
unless there is absolutely no other choice.  I am also not convinced
of the overwhelming importance of non nutritive sucking, by the way.
I see lots of babies who "love to suck a long time".  We get the
mother feeding more efficiently with a better latch and breast
compression, and amazingly the baby no longer wants to suck.

Jack Newman, MD, FRCPC