In a message dated 1/21/2005 6:41:34 AM Pacific Standard Time, 
[log in to unmask] writes:
Please comment on a premature baby who turned blue in the hospital and =
stops breathing at the breast but can bottle feed without gulping, =
choking, or gasping. Is it safe to try to breastfeed again a few weeks =
later?=20
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Usually premies have less trouble with apnea, bradycardia and cyanosis at the 
breast (but they also take in less) than with the bottle.  The only time I 
have seen a baby do better with a bottle is when:
1. Mom has not been instructed on how to support the baby's head (relatively 
large and heavy compared to the full term baby proportions), and the baby is 
actually occluding his airway while "in position" to breastfeed.  May need to 
try other positions, such as football hold to give more support to haed. OR
2. Mom has such a great let-down that she overwhelms the infant's ability to 
compensate.  You could try to have Mom pump off some of her milk first, then 
put the baby to breast so he doesn't drown!  We use this technique as we 
transition babies from non-nutritive ("dry") breastfeeding to full breastfeeding.  
Another benefit - baby gets extra hindmilk.

Nancy
Nancy E. Wight MD, IBCLC, FABM, FAAP
Neonatologist, Sharp Mary Birch Hospital for Women and Children's Hospital
Medical Director, Sharp HealthCare Lactation Services
San Diego, CA
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