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Subject:
From:
Kathy Eng <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Mon, 22 Jan 2007 19:34:35 -0600
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Dear Nina, part of the problem is assuming some LCs use bottle to 
approximate what baby does at the breast. This is incorrect -- bottles 
are used to feed the baby when intake at the breast is insufficient. 
Bottles don't solve the breastfeeding difficulty, they allow more 
caloric intake or facilitate sore nipple healing. And we must clarify 
that bottles are not used for convenience sake. The first rule of thumb 
is "feed the baby." The second is "protect the milk supply."
 
I watch how the lips grip the bottle, if milk dribbles out of the mouth, 
I watch how the tongue moves, and I watch how long it takes baby to 
remove the milk.  If baby can't remove milk from the breast but mom has 
a good milk supply, I may want to see if baby can bottle feed properly. 
I first watch the intake at the breast via test weights and see if 
supplementing at the breast improves things. Sometimes it doesn't.

I will initiate bottles if the baby must be fed more or risk health 
consequences and other methods/interventions don't work.

Kathy Eng, BSW, IBCLC

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