I have been skimming through the posts on women who are having BF 
difficulties and the LC recommends them to pump and bottle feed. Several 
said we can fix nipple confusion later on. I would question how easy 
this really is.

I find that most of the moms I work with are not able or willing to make 
their babies relearn how to breastfeed after being bottle fed for weeks 
or having been in the NICU. So many babies adapt to bottles by not 
sucking. They look like they are but they are really only swallowing. So 
you put them on the breast and they don't suck or suck shallowly and in 
too short of bursts and no milk is removed or MER triggered. The moms I 
work with say the baby prefers the bottle so they go that route since 
they do not want to work hard at the breastfeeding. They don't like the 
SNS type devices and if it doesn't work the first latch on, they won't 
try a second or third or tenth time. (The ones who will work with their 
baby to teach sucking are almost all successful but it takes days, not 
one feeding.)

Mom needs to be told the issues so she can consider and make her own 
informed choice. She needs to be told that bottle fed babies often stop 
sucking well enough to remove milk at the breast.  And be told that she 
may or may not have difficulty maintaining her milk supply on a machine. 
And told that pumping may be harder in the long run, twice the work, 
than breastfeeding. But whatever her choice is, we respect that.

Yet moms think that pumping and bottle feeding is so easy! Until they 
actually do it. Another myth propagated by formula companies???

I have had women report to me that the LC said just pump and bottle feed 
and this makes some of them very angry. The last lady like that had a 
tongue tied baby that the first LC didn't notice or know how to assess 
the tongue. She felt like she was told to pump and bottle feed because 
that was easier than the LC finding a solution or working to help her.

Kathy Eng, BSW, IBCLC

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