Hello everyone,  I have been lurking on and off for quite some time and
wanted to respond to a question Marsha Walker asked but thought I should
briefly introduce myself first.

I'm Kathy Kuhn RN, BSN, IBCLC. Mom to four sons age range 23 to 15, one of
our sons  is deceased.   I have been a private practice LC since 1988 and for
the last 1 1/2 yrs the LC at parentsplace.com.    I am from Eastern PA.

Marsha writes:

<< Jean brought up the thought about the concept of post traumatic feeding
 disorder as it might relate to infants. There was a study published on just
 this topic:

 Benoit D, Coolbear J. Post-traumatic feeding disorders in infancy: behaviors
 predicting treatment outcome. Infant Mental Health J 1998; 19(4):409-421

 While it may not be directly related to breastfeeding (the infants were
 bottle-fed), the article does point out that such things as aversive feeding
 techniques can contribute to this problem of food refusal. It also mentions
 GE reflux, feeding tubes, suctioning, etc as contributing to an infant's
 refusal to feed. It makes me wonder about the subsequent feeding problems we
 see with babies who had their head crammed onto the breast, fingers poked
 into their mouth, and bottles or pacifiers shoved into a closed mouth. I have
 had numerous mothers describe the rough handling of the baby by the nurse in
 the hospital to get the baby to breastfeed. This has distressed the mother
 and resulted in babies being discharged who are unable to approach the
 breast, let alone latch on.

 Anyone else seeing this?
  >>


 Sadly yes, all the time.   Mother's are often reluctant to see me fearing
more of the same even when they have been referred by the visiting nurses or
their ped and I reassure them I have a more gentle approach that respects the
comfort of the baby (and mom too).     I think this forceful, rushed method
of latching the baby is a reflection of the busy  hospital schedule, high
patient load, short staffing, and a lack of experience on the part of some
nurses and even hospital LCs at times.   (not all I know there are many super
nurses and hospital LCs out there)  I can imagine that sometimes there is a
sense of panic that the baby is not breastfeeding and this needs to be
resolved prior to discharge.    Absolutely it needs to be resolved prior to
discharge, but resolution can be a referral to a community based LC, helping
the mom with a pump, and teaching her how to feed the baby in the mean time.
 I often talk to moms about making sure the baby is well fed just to regain
the baby's trust that his world will be comfortable and feedings don't need
to be a battle.  Sometimes we don't even try to breastfeed for a few days, we
just feed the baby and pump.   I explain to the moms feeding the baby and
pumping has "bought us some time" to help the baby learn so we don't need to
be paniced at every feeding.   Sometimes I feel the tension leaving the mom
at this point so strongly that if tension were a physical object we'd be able
to actually see it leaving the house.  Many times just removing that very
understandable pressure of each feeding being a "do or die" situation to make
breastfeeding work is all that is needed and breastfeeding becomes
established quickly.  Others take more time.

The other thing that concerns me is alternate feeding devices being used as a
panacea.  It seems that each facility has "latched" (pardon the pun) on to
their favorite alternate feeding device whether it be cup or finger feeding
or bottles without individualizing each couplet's needs and situation.  They
have a tendency to promote their favorite device as "best" when I am not
aware of any studies that compare feeding devices against each other and rate
them on their impact as it relates to preserving breastfeeding.   Anyone know
of any?

Thanks Marsha for making me feel not so alone in my observations about what I
refer to as "nosocomial breastfeeding aversion".

Kathy Kuhn RN, BSN, IBCLC
private practice LC and
parentsplace.com LC
New Tripoli PA

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