I would love the opinions of the group regarding non-nutritive sucking. I always thought of non-nutritive sucking as being more on a pacifier than a breast. But I listened to a webinar recently in which the LC said it was normal for babies to go back and forth from nutritive to non-nutritive sucking during colostrum production at the breast. She said it forced the baby to suck stronger and longer, and pause for rests, and that this did the best job of stimulating mature milk production. So I guess this is a term that is being used for when infants are swallowing less or very little milk at breast. Makes sense to me, except I wouldn't want to use the term with a patient. For many mothers I think it could create anxiety. Often their worst fear is that the baby isn't getting enough, or the baby is starving to death at their breast. Saying the baby is non-nutritively sucking at the breast would be their worst fear come true. Plus I would think that even in this slower sucking pattern or a shallow latch an infant would just receive less milk, probably not zero milk. 
I've encountered an alternate opinion from another Provider who feels that non-nutritive sucking at the breast during colostrum production, is a sign of a feeding problem and that the infant should be taken off the breast and the feeding ended because the baby is just non-nutritively sucking. This advice is given to mothers on day 1 and 2 of life. I'm concerned that it also decreases their confidence about breastfeeding.  Now they are wondering if putting baby to breast is the right thing to do because they don't want "the baby using them like a pacifier." Often then the baby is then given a pacifier because it's not nutritively sucking, which creates many more problems. I've always been of the opinion that we shouldn't limit feedings at the breast unless their are signs of a problem, nipple pain, prematurity with fatigue at the breast and weight loss, etc. In the book, "Supporting Sucking Skills," the authors state that a normal pattern would be swallowing and breathing are integrated within bursts of 20 to 30 sucks. And that short sucking in early stages would be sucking of only 3 to 5 sucks with longer pauses. Could it be normal for babies to go back and forth? In most cases I think I would tend to advise that she use breast compressions and continue the feeding if no nipple pain or damage. It seems to me that these long feedings give the baby comfort and some food and stimulate the release of oxytocin. And the authors don't say specifically say that a feeding should necessarily be ended because at that moment the sucking burst is 3 to 5 sucks. I also think that things can change moment to moment. I often tell mothers that I'm not going to judge their babies ability to breast feed by one feeding on day one. This is just one moment in time. I try to look at the overall picture of how the baby has been doing over the past day. Any wisdom from the group would be appreciated. Thank you.
Sincerely,
Tricia Shamblin, RN, IBCLC 





             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome