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Wed, 13 Sep 2006 10:51:44 -0400 |
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In our 84 bed NICU we have not had success with using a supplementing
device at the breast for premies.
We think it is because premies often have multiple problems with feeding
including lack of stamina, difficulty with flow control, difficulty
coordinating suck-swallow-breath, immature muscles that prevent a strong
latch, to name a few. A supplemental device at the breast can exacerbate
their difficulties coordinating flow-control and suck-swallow-breath, while
also breaking the seal that their otherwise weak muscles may have made at
the breast, reducing their ability to produce the negative pressure needed
to suckle effectively. Additionally, at follow-up developmental clinics,
there are many annecdotal reports of poor long-term feeding outcomes for
premies that had early negative feeding experiences (i.e., experiences
where they were "forced" to take more than they could reasonably handle at
the breast). We want to avoid this kind of situation and try to set
everyone up for success.
The best breastfeeding outcomes we have experienced with premies come from
routine kangaroo care, maternal responsiveness to infant feeding cues,
early and frequent time to explore/learn at the breast, use of an NG tube
to provide the bulk of the required nutrition, and time. A 20mm nipple
shield can also provide good help with latch as the infant grows stronger
and more coordinated.
I would be interested to hear if others find that the supplemental systems
do work with premies.
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