Karen -- I think your teachers and Cathy Genna are on the same page.  She
isn't saying to pull the nipple/teat out of the mouth to "create" a pause
... but rather to take advantage of the pauses the B naturally will offer in
the course of a feed.

If I understood it all correctly, Cathy was telling us that the idea is to
respect the natural pauses that the baby takes.  In the course of any feed
-- at breast or otherwise -- a baby may want to stop, and rest, or ponder
life, or take a breath, or organize a bolus for swallowing (remember --
these are babies whose breastfeeding skills are already compromised, if we
are using paced bottle feeding as part of the therapy).

The idea of having the nipple/teat pulled out and rested *on the lower lip*
was to avoid stressing that baby into now having to wonder "What happened to
dinner?  I was just getting the hang of this and they snatched my plate
away."  Leaving the nipple/teat within range of smell, taste and feel is
much more akin to the baby who says latched, but not suckling, on a breast.

I have heard others IBCLCs say they prefer to use a technique where they
"tip" the nipple/teat toward the roof of the mouth during the pauses, while
keeping it in the mouth.  This avoids having those drips that come out of
the bottle ... landing on the tongue when Baby least expects it or can
handle it.

Is this compatible with the teaching you heard?

-- 
Liz Brooks JD IBCLC
Wyndmoor, PA, USA

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