Betsy refers to moms who are fed up with finger-feeding or a  
supplementer after a few days. She speaks of walking into the home  
(as a visiting nurse) and the mother is not willing to use such  
methods any longer. I also have had this happen many times, when I am  
just seeing a mom for the first time at a week or more. I find that  
this typically happens because the hospital instructions never  
referred the mom to an LC and simply left her hanging with these  
tools. When I ask what the protocol was for returning to breast or  
when mom was instructed to re-evaluate the device, I am told that she  
was just supposed to "keep trying" at the breast.

It is wonderful that hospital personnel are trying to avoid  
immediately resorting to a bottle, but improper use of these tools  
means that I am now left with fewer tools at my disposal with which  
to help the mom. It is often the very early days when finger-feeding  
can be most helpful, and when there is immediate follow-up into the  
home, it can be a pretty rapid transition to breast for those babies  
who just needed to organize their suckles, wake up a little bit or  
get a jump start before mom's milk is in. I would really encourage  
anyone working in a hospital setting where this happens often to  
educate the staff in their proper use (primarily nurses, although I  
have seen the same kind of advice from doc's offices where there is  
no follow-up scheduled for a week or more). Every single day is so  
important in the first week and moms can reach exhaustion very  
quickly. A smooth flow of support can be so important to assuring the  
successful use of interventions.
Jennifer Tow, IBCLC, CT, USA

> ------------------------------
>
> Date:    Mon, 22 Jan 2007 06:43:32 -0500
> From:    "Betsy Riedel,RNC,IBCLC" <[log in to unmask]>
> Subject: bottles and assessing sucking
>
> Sometimes, we have to resort to a bottle when baby is having  
> ongoing issu=
> es=20
> and not getting adequate milk from the breast. As a nurse (and LC)  
> who wo=
> rks=20
> in the hospital and often follows mothers and babies after they go  
> home=20=
>
> (through the VNA), I find that when I am dealing with a couplet  
> that has =
> more=20
> than thecommon couple of days worth of feeding issues initially, it  
> is th=
> e=20
> parents who get sick anad tired of finger feeding or cup feeding.  
> It is u=
> sually=20
> the mother who tells me (as I walk in the door) that she just  
> cannot fing=
> er=20
> feed anymore and that she has put her milk in a bottle. Having to  
> use the=
> =20
> suppplemental feeding system gets to be too much after a few days  
> as well=
> .=20
> Alternative feeding methods are great as a short-term stop gap  
> measure, b=
> ut=20
> sometimes problems drag on a lot longer than that.
>
> I know I have mentioned this before, but I would be interested in  
> knowing=
>  if=20
> any of you have tried the "Breastflow" nipple by First Years? I  
> came upon=
>  it=20
> totally by accident (a mother I was following went out and bought  
> one) an=
> d I=20
> have to tell you, I was amazed at how different this nipple was in  
> compar=
> ison=20
> to the others we all know. The baby has to use suction AND  
> compression to=
> =20
> get the milk out and it come out very slowly as well. the mouth has  
> to be=
>  very=20
> wide open also.
>
> Personally, I'd rather see a mother who is happy giving her baby  
> her milk=
>  in a=20
> bottle while we as LC's are working on getting the baby to breast  
> and mor=
> e=20
> important, protecting 9and increasing) her milk supply at the same  
> time.
>
> Betsy Riedel RNC, IBCLC
>

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