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Subject:
From:
Pia Ruohotie <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 12 Feb 2014 20:42:02 +0200
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Hello all!

It has been awhile since I last posted anything here. I have been working in NICU (level 2B) and postpartum settings and as an breastfeeding coordinator in Helsinki University Hospital.

In neonatal wards setting the use of pacifier is a different than in any other wards (also surgical intensive care units and other pediatric wards where infants are being nursed). The new-born baby and infant needs sucking. If we have family-centered hospitals, then the mother will be present and can provide breast for comfort and nutrition in many cases, but not always the newborn babies or infants are stable enough to be at the breast. Then the pacifiers can give infant a source of comfort and also learning until she / he can be put to breast. Kangaroo Care Method should be used.

If the baby loses His/her mother and somebody other is taking care of he/her, and that someone else is not able to breastfeed / or the baby is not able to be breastfed, then developmentally she / he needs the pacifier or bottle nipple to be able to feed and get comfort like human babies need. Cup-feeding or any other alternative feeding method is needed when the baby is going to be breastfed as soon as possible. Of course there can be problems with bottle-feeding and pacifiers in developing countries since clean water and safe formula-feeding is not always possible. Maybe then the cup-feeding is less risk regarding hygiene but the babies would still need sucking emotionally (comfort) and for development.

I have seen a change in last 6 years in Helsinki University Hospital, most of the sick or premature babies will be exclusively or partially breastfed at discharge and now most of the mothers can provide expressed breastmilk for the babies. More family-centered methods are being used in neonatal wards and a new family-centered NICU is under construction. The changes and new family-centered NICUs are under construction or planned to many of the other university hospitals in Finland also.

Warmly,
Pia Ruohotie, RN, IBCLC
From Helsinki, Finland, Europe


> Pamela Morrison:
> I was very interested to hear about your previous work in this 
> area.   Is there any possibility that you might have looked at a 
> possible connection between infant sucking needs and the development 
> of cognitive/motor skills??  I ask because of my concern about the 
> recommendation for cup-feeding in developing countries for babies who 
> cannot be breastfed - I've known of two cases of developmental delay 
> which only resolved after orphaned African babies being cared for by 
> their grandmothers and exclusively cup-fed were finally fed with bottles.

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