In a message dated 4/24/99 2:17:56 PM Eastern Daylight Time,
[log in to unmask] writes:

>  am I missing something? Why would an LC recommend nipple shields which are
>  known to cause nipple confusion? Why would an LC recommend using bottles
>  instead of an SNS?
 Rachael,

A bottle and nipple shield may help a mom and baby not yet able to do well on
breastfeeding alone or who may not be able to manage an SNS.  There are many
reasons beyond just plain nipple confusion that are the cause of a baby
having trouble.  I believe many problems with simply positioning and latch-on
have been labeled nipple confusion because no one knew better and could give
mom the help she needed.  Compromised sucks may easily have been the root
cause of other problems that required supplements and then were  mislabeled
in the past as nipple confusion.

Read JHL and Breastfeeding Review from the last couple of years as well as
recent Lactation Consultant texts.  You might also do a review of lactnet on
these topics.  There are a ton of great posts on this topic.  In the
meantime, keep an open mind and soak up all the learning you can!  There are
pros and cons to all tools.  All tools have appropriate and inappropriate
usage going on.  The key is getting skilled enough to use the most helpful
tool at the helpful time-- where the benefits outweigh the risks.  And there
is also the need to keep in mind the individual mother and baby as the choice
is made.

As for your cousin, encourage her to have Follow-up with the LC until they
have reached their breastfeeding goals.

Natalie Shenk, BS, IBCLC
Ohio, USA

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