Dear Wise Ones:
I know I am not alone with the battles of: "perceptions of low milk supplies
and infants not getting enough at breast".  Then there are supplements of
large quantities of formula and scheduled feedings.
The approach I have tried to use is to educate the mothers and staff.  But
this is not working.  So I started to watch more of the formula feeding.
Starting right after birth, the assumption is made that the newborn needs to
eat within 3-6 hours, 30-60 cc.  Then they are feed every 3 hours after that
with bottles filled with 120 cc (or more) and allowing the babies to consume
whatever amount drains in.
This feeding schedule is not based on feeding cues: rooting; mouth to hand,
if these are observed before the scheduled 3 hours, pacifiers are used.
When these babies are being feed, the nipples are sometimes forced into the
corner of their mouths and the jaw or throat is massaged to encourage
continuous swallowing.  If a set amount is determined to have to be
administered, all means are used to get this in without any observation of
how the baby is handling this.
I have observed gagging, eyes widening, spade hands and the formula pouring
out the sides of the baby's mouth and the nurse continues to push the feeding.
I asked a nursing instructor if I could observe her teaching her students how
to bottle feed and she said she really does not teach this.
I am sorry for the length of this post but I am pleading with this group on
the need to approach this long standing thought process on bottle feeding.
How did this all start?  Any ideas to best approach this?  PLEASE I need your
input.
Until bottle feeding mimics breastfeeding, I think we are fighting a losing
battle.
Ann Perry RN, IBCLC
Boston, MA

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