Hi, Sheila and All:  Pacing feeding means that the person being fed (either 
by others or by himself) the food is going in at a rate comfortable for 
that person - not too fast, not too slow, and a comfortable amount 
(bolus).  Everytime food goes into a person's mouth, the feeding is being 
paced.  We all automatically and without prior thought pace our own 
feedings, putting the food (either solid or liquid) into our mouths at a 
rate that is comfortable for chewing/swallowing.  Feeding oneself is easy - 
we automatically "pace" ourselves.  Feeding another person is an entirely 
different story.  Last year, myself and our therapists co-presented an 
inservice to the staff on what it really means to feed and be fed.  We 
passed out a sport bottle of water with the squirt top to each nurse, along 
with a handful of paper towels.  We got laughter and questions as to why 
they would need paper towels.  The therapsists then did a power-point 
presentation on the anatomy/physiology/neurology of feeding, including why 
it is important to help a baby pace feedings.  We then had the nurses pair 
off and feed each other using the squirt bottles.  They were not allowed to 
put their hands up by their faces, or help themselves in any way (after 
all, babies can't) during the "feeding". As protective defensive behaviors 
were displayed by the "feedees", the therapists pointed them out and 
explained these behaviors.  After much laughter, choking/sputtering, and 
getting a little wet, the nurses realized how important it is to allow baby-
led feedings and how important paced feeding is for a baby who is immature 
or otherwise compromised. They also learned why breastfeeding is so 
much "easier" than bottlefeeding!

Pam Hirsch, BSN,RN,IBCLC 
Clinical Lead, Lactation Services
Advocate Good Shepherd Hospital
Barrington, IL   USA

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