> meantime I
> think I'd rather let them bottle feed than start a shield before the
> milk is in.
> Why? I've never seen a baby effectively extract colostrum through a
> shield. If I
> were to start a shield at this stage...I'd be very concerned about
> the baby's
> hydration and the mom's supply. If I am going to use a shield
> anyway....why not
> use a bottle (like a Haberman, Avent...) and then work back to the
> breast with a
> shield once the supply is established with effective pumping?
> Susan Keith-Hergert RN, MS, CPN, IBCLC
> Mercy Health Partners
> Cincinnti, Ohio
Susan,
Just my .02 worth.  As a hospital LC , I have seen babies transfer
colostrum from the breast many times with a shield (thin silicone type).
I do think the mother has to be instructed and shown how to latch the
infant properly.  Instruction in Sx to look for indicating proper
hydration.  The shield has saved breastfeeding many times for mothers I
have assisted.  I also believe that having the baby attached to the
breast,,even with a shield , allows for the transfer of milk faster and
easier than pumping.  At least the mother is holding the baby, baby is at
the breast..  Some mothers have a real problem with MER using a pump.
Some new mothers go home pumping and finger feeding or cup feeding find
it too stressful and so much work they stop breastfeeding and go to
formula.  I have had babies that need only one or two feeds with a shield
and then go to breast after that.  I also have a mother using the shield
use breast compression, thank you Dr.Jack.
We all have our techniques and every M/B dyad is unique.  We have to make
the assessment and do what works for that M/B dyad..  It is too difficult
to make a blank statement about what we should or shouldn't do.  When you
are the one with the patient. you are the expert.  Bottles do not teach
an infant to suck correctly.
Thank you,
Darlene Breed, BSN, RN, IBCLC
Coordinator, Milk Bank & Breastfeeding Center, Worcester, MA (USA)
Treasurer, Human Milk Bank Association of North America (HMBANA)
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