This is the thought I had when I read two somewhat similar problems
presented by Chayn Nancy Fogelman IBCLC Israel and also the plight of the
Malaysian mother.
<Baby started going to breast briefly with nipple
shield but still ate primarily ebm. Over time the baby became more reluctant
to latch at all. When I got there, baby then 4 months old, he didn't want
anything to do with the breast. He did latch on momentarily
without sheild but mostly screamed at the breast even after eating from the
bottle.>
I believe the markedly different flow rate of the breast compared to what
each of the adults has "trained" baby to expect from a bottle is at least
one of the factors at the bottom of such problems. It is hard to persuade
most experienced adults from their instinctual certainty that "the speed at
which the baby takes the bottle is a sign of how hungry he really is, and a
loving adult should let the baby set the pace."
I have had success with some WIC mothers when this occurred by 1) Helping
them understand that the breast must never become a battleground. Arrange as
many pleasant skin to skin experiences as possible, including, if necessary,
bottle feeding cheek to breast. 2) Re-teach the baby to bottle feed so that
the baby "unlearns" or overlays the experience of immediate, constant flow
at breakneck or "firehose" speed with adult-paced flow, using slow flow
nipple, if available.
I teach them that it's important to insert frequent pauses in bottle
feeding, every 4-5 breaths or so, by leaning baby and bottle forward for a
moment, with mom reassuring baby in a pleasant voice "I won't let you
starve! I won't let you choke!" and quietly, smilingly, affectionately
telling the baby her story, such as "We're going to learn a new way
together! I know we can do it!" In "acting out her script" in this manner,
the mother "calms" her own body language, and also reassures herself
that she is in no way "mistreating" the baby by taking charge in slowing the
flow rate.
If a mother can believe in herself and in this plan enough to combine these
things with continued support of the milk supply by frequent pumping, using
breast compression frequently and always elicting the MER when "enticing"
skin to skin at night, and upon earliest hunger cues and/or when baby's
hunger is partially satiated first with some formula at other times of the
day, I have had a number of mothers succeed in "reprogramming" babies to
stop rejecting the breast immediately while learning to accept its natural
flow rate. I think it's worth a try.
Jean
**************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA
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