Re: Kathleen B's 36-wker "addicted" to rapid flow -
I agree with what Patricia said about reducing flow gradually. But I would
really concentrate on *not* setting this kid off by too much messing around.
These "0 to 80 in three seconds flat" babies really need to have that low
frustration threshold respected. In my experience, when you push them, they
resist more strongly. (Also, in my experience, these often turn out to be
the extremely bright kids, for whatever that's worth!)
So I would not let this baby set up an aversion to the breast - give it what
it wants, and try to gradually lull it to breast once it's no longer hungry
and/or mad. I will admit right here in public that I often use a bottle to
feed these babies, especially at night; at least to start them off on a
feeding if they're getting crabby about the breast. I use an Avent or
Munchkin nipple if available (they're not readily available here) because of
its wider base (but not a Playtex "Nurser" - too wide), show the parents how
to get the baby in the habit of a wider latch than usual at bottle, and make
it as much like BFing as possible - make the baby put its tongue forward
over gum line, feel nipple along length of its tongue, etc. I'm happy to
work with finger-feeding, dental syringe at breast, SNS, or whatever, but I
find that many parents just can't face working with all the "stuff" - they
say it takes too long, etc., and just give up. So I say, OK, we'll do what
works, and keep it as simple as possible, always working towards our goal of
getting baby to breast.
Anyway, I bet the trick to this baby will be to keep from getting his back
up about going to breast, and letting the baby tell you what pace to move at
as you try various techniques. (I'm assuming you've ruled out anything like
sore mouth from thrush, etc.)
Good luck! In my experience, these babies almost always go to breast when
*they* decide the time is right, IF the parents can hold out long enough and
don't just throw in the towel out of frustration with fussy techniques.
Cathy Bargar, RN< IBCLC Ithaca NY
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