I am in the process of writing care plans/treatment plans for breastfeeding problems so everyone is doing the same thing here at our hospital. The first problem I am addressing is cleft palates/lips.We have a baby with a bilateral cleft lip and palate and everyone is wanting to do something different--bottles, Haberman, Pigeon, Regular nipples, SNS. I have a question about the feeders for babies with clefts. I have always used the Haberman Feeder for clefts because I like the longer length of the nipple, and the regulation of the flow. Some of our nurses like the Pigeon Feeder because it is what has been used in the past ( again I am meeting resistance to change). The supervisor is concerned about the Pigeon because it is from a foreign country and we don't know if the chemical contents of the nipple ( it is the dark orange rubbery nipple) meets the FDA standards. Also their instructions are in Japanese so we can't instruct the patients. The next concern is that the hard portion of that nipple rubs the lip and creates a sore place. So my questions are:
What do other facilities use and why? Has there been any studies on the effectiveness of these feeders?
This baby has a bilateral cleftpalate and lip but has been nursing beautifully. He is losing weight so the MD wants to supplement after each feeding-expressed breastmilk is fine. Mother is pumping and has a great supply. She does not want to use the SNS-tried it and did not like it at all. The mom checked out of the hospital yesterday to go home to care for a sick older child and the baby is staying at the nursery as a boarder due to weight loss ( 11% of birth weight). So he now has to be fed by the nurses.
I think the weight loss is due to feeding on a 3 hour schedule and would like to suggest going to a 2 hr scehdule. The Nurse Practitioner just now questioned me on why we are not using the Pigeon but using the "new type" of feeder.
Thanks for your input.
Barbara Whitehead,BS, IBCLC

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