Diane, you bring up some good points about using the bottle appropriately to
help with breastfeeding problems. Maybe judicious use is far better than
trying to convince a reluctant mother than cup feeding or finger feeding or
whatever is the only way to go. I try to leave choices up to mothers
(including a bottle if she feels she needs to) because I don't know what she
can tolerate. Some mums simply can't put up anything outside the "norm,"
while others would finger feed hanging from a chandelier if they thought it
would help. I've had mothers report that feedings improved dramatically
after they'd used a soother for awhile, or "broke down" and used a bottle
for a feeding so these aren't things I'd totally, always, rule out.

That said, however, it's important that mothers are allowed to make an
informed choice about anything we recommend as an alternative to the baby on
the breast, so we need to be honest about what we know (such as that in the
experience of many LCs, using a bottle in the early weeks can cause problems
at the breast).

Molly Pessl's editorial in the recent issue of JHL was excellent--she
challenged us to keep open minds and be flexible and inquiring. I don't want
to practice in a profession where questioning and experimenting isn't
encouraged, where there are articles of faith that can't be examined for
fear of condemnation. This debate needs to take place appropriately,
however, so that it doesn't become an ego battle of one method vs another,
one country against another, one LC against another. I've experienced this
at seminars and ILCA conferences and I don't like it--it's highly
unprofessional and counterproductive.

Leslie Ayre-Jaschke, BEd, IBCLC
Peace River, Alberta, Canada