Anna writes:
<She is 3 months and 11 days old now>
<Baby now takes 4-6 oz bottle every 3 to 4 hrs and is now able to
maintain sucking unless she is tired, when mom reverts to pacing.>
I don't have my table of amounts handy, but my first reaction is that for
a baby this age (weight???), 6 ounces at any one time is too much. It
sounds as if the baby may be habituated to a relatively rapid steady flow
free of any pauses, filling or perhaps overfilling the stomach long
before the full 20 minutes necessary for thorough digestion and
absorption of the first part of the feeding to start signaling the
satiety center in the brain.
For the adult to refuse to permit what I call "chug-a-lugging" and
deliberately pace a slower flow rate, with regular small pauses, helps
establish a young baby's expectation for 'pulses and pauses' continually
during the feeding. This is imitating one aspect of human milk transfer
during breastfeeding, and I have found it to be an important first step
to persuade adults to honor this time lag to re-establish this
expectation in the baby before trying to re-establish direct
breastfeeding. It would also seem of benefit in establishing more
leisurely and healthful eating patterns to reduce risk of future obesity
in babies who are bottlefed. (Would that my parents had been taught!
Rapid eating was rewarded in my family, and is a very hard habit to
break!)
It's been my experience with WIC moms (and in retrospect with my own 6
children and the countless babies I fed in the hospital over 24 years of
hospital maternity nursing) that many of us adults may have some of this
backward. We have become accustomed to interpreting a baby's relatively
fast and efficient eating as obvious proof of the degree of hunger, and
that if we don't see any outright signs of choking or fatigue, we assume
it's "efficient eating" for the baby to "pace" the bottle however s/he
manages to do so, even if it seems like "wolfing it down".
I believe it is closer to the truth to say that the young baby has very
little power to "pace", but more likely "tries to keep up the pace" of
the rubber nipple, which differs by manufacturer, the temperature of the
milk, and the vigor of the particular baby's sucking, including any
tongue motions made to try to slow the flow, but which often end up
causing further flow every time the rubber nipple is compressed in any
way.
Jean
************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA
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