Regarding this discussion of use of bottles for assessing sucking or feeding I want to add my observations and research. First, babies are natural at breastfeeding not at bottle feeding. I am not talking about the babies that have problems just in general, natural terms. There is the assumption that babies do fine with bottle feeding and that EVERYONE knows how to feed babies with bottles, so therefore there needs no education on how to perform this task. This is the research I have been doing on my own for the past several years, looking for teaching of bottle feeding in infants. This is what I have found. In the past couple of years members of the lactation field have done some work on "paced bottle feeding" and this seems the most appropriate place to start. We in the lactation field should be the experts on normal feeding of babies. The companies that make bottles and formula there is no instuctions or research. If folks have not seen Barbara Wilson-Clay's DVD from her and Kay Hoover's latest issue of "The Breastfeeding Atlas", I highly recommend it. She shows and describes paced bottle feeding and one can easily see the differences it makes in a baby when they are more in control of the flow. Another resource that I am only partially knowledgeable in is NOMAS. What this stands for is at work and I am at home. I know there are folks here on LACTNET that have attended their workshops and please chime in. This workshop deals with feeding of neonates and looks at bottle feeding. One lecture I heard who described what she learned from NOMAS was that if the baby is in rapid sucking this is non-nutrive sucking so one would want to tip the fluid out of the nipple so the baby is not taking in a bolus because they are not anticipating to coordinating a swallow. The person feeding the baby needs to watch for the baby's readiness to change to the long, slower drawing suck and this is when to allow milk into the BOTTOM HALF of the nipple so the baby can take an amount they can control. I have been trying to teach the nurses and parents how to properly bottle feed their babies. I talk about waiting for the baby's readiness and rooting. The baby needs to be sitting up and the bottle will be slightly tipped back with the teat toward the baby's palate. (This is well demonstrated in Barbara's DVD.) Then watch the baby's sucking pattern to determine when he/she is ready to take a swallow. I review signs of babies that they are not handling the feeding and need a break. These include milk spilling out of the sides of the mouth, coughing, choking, hic ups, hands spaying, baby struggling, and eyes starting to fade shut. I have written to Karen because I think we are on the same path and will try to reach her again on work she has done. One more note on bottle feeding training baby's suck. In Barbara's DVD she does show that with the pulling out of the nipple when giving the baby a breather, this break of suction does help them develop a better and stronger suck. Barbara please chime in on this anytime. Do others agree with the observation that health care providers and the public just assume that everyone knows how to bottle feed a baby? Bottles are a tool and very ingrained into society, we just need to learn how to use them properly. Ann Perry, RN IBCLC Boston, MA *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET email list is powered by LISTSERV (R). There is only one LISTSERV. To learn more, visit: http://www.lsoft.com/LISTSERV-powered.html