Darillyn Starr wrote:

 A while back, I started writing on getting an older baby to take the
 breast.  I did not ever see it in a digest though, so I am reposting it
 after this.

 Once the baby seems fairly comfortable and secure in his new
 surroundings, start working toward getting him to take a wide based
 bottle nipple with the feeding tube of a supplementer positioned
through the hole in it.  To do this, use a new nipple with a small
hole.  Do not do anything to enlarge the hole.  It needs to be tight so
that the tube will stay in place.  Get a very large needle and thread
the feeding tube through it, then pull it through the nipple hole and
position the tube so that it is extended through no more than one
millimeter.

 The objective is to feed the baby with the bottle nipple positioned
 directly over the breast.  The nipples that work the best for this are
 the wide-based, ortho nipples designed for bottles that use plastic bag
 inserts, or the nipple to the Avent bottle, but be sure to get the kind
 that have only one hole in them.  These nipples cover the breast better
 and do not collapse when the baby suck on them without the bottle
 attached.  If the baby has not been taking one of these type bottles,
it may first be necessary to give him one for a while before attempting
the supplementer tube/bottle nipple combination.  Either the SNS or
Lact-Aid can be used for this purpose.

 To use the tube/nipple combination, start out holding the baby as he is
 accustomed to for bottle feeding.  Put the nipple in his mouth and let
 him start sucking.  It he objects or wants to play with it because it
is different, put it on top of a bottle, put it in his mouth and then
try to remove the bottle once he has settled down and started sucking.

 With the tube/nipple in his mouth, turn him toward the breast.  The
 objective is to get him to accept being in the exact position as for
 nursing, with the mother's breast exposed in the way she would for
 nursing, so that the only difference is that he has a bottle nipple in
 his mouth, rather than flesh.  This position is so intimate, that many
 babies who have been traumatized are frightened by it, so getting the
 baby comfortable with it is a big step.  I, as well as other mothers,
 have felt a great sense of relief just having the baby in this
 position.

 Once I got to this point with Julia, I decided not to try to make
 anymore changes for a while and kept feeding her with the tube/nipple
 for a week or so before I tried to make any other changes.

 I will write more on this later, so that this post will not take up the
 entire digest!

 Aloha,
 Darillyn


> Darillyn Starr wrote:
> >
> > The recent posts on making bottlefeeding more like breastfeeding lead in
> > well to the topic of converting an older adopted baby to feeding at the
> > breast.  Many of the suggestions given are part of the process.
> >
> > The idea is to slowly introduce the experience of nursing to the baby.
> > Before we adopted Julia, I really had not thought much about all of the
> > subtle differences that there are between the experience of bottle
> > feeding and that of breastfeeding, but there are many, and it is
> > important to take them all into consideration.
> >
> > It is important to evaluate the situation with the baby.  The baby's age
> > is a big factor in how patiently and carefully the adoptive mother
> > should proceed.  However, other factors are similarly, or even equally
> > important.  A baby who has been with one acceptable caretaker prior to
> > placement is likely to accept changes more readily than one who has been
> > traumatized by changes in caretaker, abuse, neglect, or traumatic
> > medical procedures.  Babies who have been traumatized are likely to
> > panic at anything that is new to them.
> >
> >  It is a very good idea to postpone significant changes in feedings
> > until the baby has had a chance to get accustomed to his new
> > surroundings.  For some babies, a few days may be sufficient.  For
> > others, it may require more patience.  During this period, it is
> > important for the adoptive mother to have as much close contact as the
> > baby will comfortably accept.
> >
> >  With my daughter, Julia, I had to take it very slowly. Trauma from
> > painful medical procedures, emotional neglect, and changes in caretaker,
> > had left her suspicious of everyone, and she became very easily upset by> anything that was new to her.  When we first brought her home, she
> > wanted little to do with me.  The only way she would allow me to hold
> > her was facing away from me.  So, I spent a few days carrying her around> on my hip, facing away.  This helped alot in getting her to accept me and I was able to progress, first to carrying her on my hip facing me,
> > and then to a sling.
> >
> > Incorporating as many aspects of breastfeeding into the baby's
> > bottlefeedings is important.  Having the adoptive mother feed the baby,
> > rather than allowing everyone else to help out is important.  Switching
> > arms is important and holding the baby as close to breastfeeding
> > position as possible.  Trying to get the baby to open his mouth first,
> > rather than poking the bottle nipple in is a good idea, if the baby will
> > do it.
> >
> > If at any point, the baby becomes upset by an attempt at changing
> > something, revert immediately to the previous thing.  There should be no
> > force at all.  Attempts to force the baby, such as refusing to give him
> > anything to suck on until he takes what he is offered, are
> > counterproductive.  One of the most important objectives of this whole
> > thing is to teach the baby that he can trust his adoptive mother, and he
> > is not likely to learn this if he cannot depend on her to feed him in a
> > way that is comforting to him.
> >
> >
> >
> > Aloha,
> > Darillyn Starr
> >
> >