Knew I was going out on a limb with this discussion...I do not disagree with
a single thing any of you have said, in fact I largely agree.
Notwithstanding, in an environment where I  am an anomaly in encouraging
demand feeding, teach baby directed feedings, spend lots of times with
patients to assist them breast feed, and the majority of nursery nurses pop
pacifiers in babies mouths, and/or parents bring their own...I pick my
battles!   I do inform parents of the risks associated with pacifier usage, I
do encourage co-sleeping and unrestricted access to the breast, and I do
suggest - "topping off" feeds...but if they are going to be used (we do not
go home with parents), and/or if in the case of tired/exhausted moms where
RNs and MDS alike will suggest "don't be a human pacifier; or just one bottle
won't hurt" etc. I find instructing pacifier usage helps.

As far as the biter/thruster - all I can say is my experience that along with
finger training I have seen some these babies demonstrate correct sucking at
breast at the same time they 'learn' to suck correctly on the certain type of
pacifiers.  There is no "evidence based' for this - just over 15 years of
anecdotal experience..but aren't many of our practices  started that way?

sorry to rant but I worked all night last night (with some one elses patient)
with a patient from Japan who desperately wanted to breastfeed but had been
told she couldn't because her breast tissue wasnt large enough!!!!AAAGGHH!
After eliminating bottles, this kid was classic nipple confusion, drop
feeding because I can't do anything else(per admin), he finally latched
beautifully, sucked well, and did great with an SNS.. Mom and Dad were
ecstatic!!  Now I get to go back and see what happened today since the nurse
who said this baby couldn't is the assigned nursery nurse today(and they are
supposed to be the ones who assist with breast feeding issues)...

Liz Benbrook RNC, IBCLC

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