"When a bottle is wide, the parents end up tipping the baby's head back
further to get the last of the milk into the nipple. This reinforces
shoulder and back arching -which exacerbates a tongue-humping situation."
I agree with this statement 100% - which is why I teach parents to keep the
bottle perpendicular to baby's face - and to keep proper body alignment - no
tipping of the head - if bottle is emptying and parent needs to get more
milk in that nipple lean the whole baby back - not just the head!
I also like the sidelying position of bottle feeding - if I could just get
parents to try it more than once...they just don't warm up to it well here -
or at least the parent's I work with.
And Jane I am chuckling about the practice size...you only see 40 - 60? I
don't see nearly that many per month! :) However all I see in my private
practice (I don't work for anyone else) are babies with significant issues.
I had only 1 baby last year who had no issues at all where the consult was
simply positioning on mom's part. I could have done that one in my sleep!
The babies I see are typically older - a couple weeks to a couple months -
they are train wrecks because usually some other HCP (LC (with limited
experience), Dr, Nurse or midwife) with good intentions continued to fuss
around trying this and that and missing the actual cause of the problem for
weeks, while mom and baby were struggling, rather than refer out, ask for
help, something other than waiting until things are so bad that they finally
say, "well maybe you should call a Lactation Consultant." This is one of my
major pet peeves. Then Mom calls me, I am her last ditch effort and if I
can't fix it she is DONE with breastfeeding. Sigh...so unnecessary. Then I
have a train wreck to clean up and often times we (mom and I) can do it, but
with significant effort, often expense (that could have been avoided) and
excessive amounts of time (on my part for free support), and sometimes we
can't (which breaks my heart). Then we have angry frustrated moms wondering
why their midwife was acting like an LC and why other HCP's didn't recognize
that baby had significant structural issues or (worse) a tongue-tie
(especially the obvious ones...).
But it is what it is. I love reading about others' practices and what you
are all seeing and discovering...fascinating stuff and we can all learn so
much from each other!
Warmly,
Jaye
Jaye Simpson, CLC, IBCLC, CIIM, MoM
Breastfeeding Network
www.breastfeedingnetwork.net
-----Original Message-----
From: [log in to unmask] [mailto:[log in to unmask]]
Sent: Wednesday, January 25, 2012 6:35 AM
Subject: Re: Breastflow
Jaye, one other factor that I have noted with bottle-feeding is the width of
the bottle. When a bottle is wide, the parents end up tipping the baby's
head back further to get the last of the milk into the nipple. This
reinforces shoulder and back arching -which exacerbates a tongue-humping
situation. It also increases the flow of fluid through the open hole of the
teat due to gravitational pressure and fluid dynamics. If at all possible,
I encourage side-lying bottle-feeding to mimic the breastfeeding posture,
teasing the tongue out and letting the baby pull the nipple into the mouth,
etc. If a baby has a good seal, good tongue control, vacuum, etc. and mom
has good milk supply, any bottle should be OK. Maybe I don't have as big a
practice as you and haven't seen as many (I only see between 40-60
outpatients a month), but I don't see very many clients where a simple
positioning and latch technique education is the issue. About 95% of my
clientele have tongue-ties, torticollis, jaw asymmetry, mammary hypoplasia,
etc. Moms with engorgement and nipple soreness due to poor latch see other
practitioners. Many days I would LOVE to see that kind of issue instead of
a 10-week old baby with a bad tongue-tie and mom with very little milk!
-----Original Message-----
From: Lactation Information and Discussion
[mailto:[log in to unmask]] On Behalf Of Jaye Simpson, IBCLC
Sent: Tuesday, January 24, 2012 1:55 PM
Subject: Re: Breastflow
Re: Breastflow and compression.
Hi All,
Just to be clear - I am not talking about jaw compression when I am talking
about compression with the Breastflow bottle. I am talking about the tongue
compressing the nipple in a manner similar to but not identical to what the
tongue does on the breast when nursing. In the ultrasound video we watch
the tongue do a nice compression of the breast (what we used to call a
peristaltic wave) and the tongue drops down in the back causing the negative
pressure to pull the milk out. (my poor terminology but I hope you get the
idea). If a baby has poor tongue motion then they will compensate and
'chomp' on the bottle in order to get their milk - just as they compensate
on mom to try to nurse. But if a baby's tongue motion is that poor, I won't
recommend using the Breastflow.
I always teach proper bottling as if parent's do not know how to mimic BF
with bottling then regardless of the bottle the baby's abilities/skills will
suffer which will cause problems with the nursing. I don't care what bottle
a parent is using: If it is used incorrectly the bottle is not
(necessarily) the problem - the technique is. Parent's MUST be taught
properly and far too many are not which results in issues with
breastfeeding.
Just wanted to clarify. And as we all know - not all bottles will work for
all babies. Some of my babies don't like or do well with the BreastFlow so
we switch out to something different. It's all about options and knowing
how to use them - and knowing how to teach the parents how to use them.
Warmly,
Jaye
Jaye Simpson, CLC, IBCLC, CIIM, MoM
Breastfeeding Network
www.breastfeedingnetwork.net
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