I'm a speech pathologist and IBCLC. I worked NICU and well baby as a feeding/swallowing specialist and was the person they called when a baby was mysteriously having de-sats while feeding. It *sounds* like we are missing some information. The scenario doesn't really make sense. I wonder who did the bottle feeding and what type of feeding methods and nipple they used. Are we positive there was no de-sat with bottle feeding? Is the baby on pulse oximetry now? Unfortunately nurses (and sometimes parents) are not always the most accurate in reporting de-sats with bottle feeding for a wide variety of reasons. It is extremely unlikely that a baby who de-sats at breast does not de-sat with the bottle. I have only seen that scenario a couple of times and it was with preterm infants who had a hard time dealing with a pumping mom's robust MER or ample supply but could tolerate a *very* controlled feeding with a very slow flow nipple and lots of pacing and regulation from the feeder. It doesn't sound like that is the kind of baby you are describing. I have also heard of a case where a mother with very large breasts that weren't adequately supported during feeds unintentionally caused some de-sats by sort of smothering her baby with the breast until the LC assisted with positioning. I cannot really think of many reasons why a baby would de-sat at breast and not with a bottle. We have ample evidence that feeding at breast is almost always "safer" from a suck-swallow-breathe and airway protection standpoint.  

I'm not sure this response was too helpful, other than to confirm your suspicion that this situation doesn't sound right! 

-Laura Wasielewski, MS, CCC-SLP, IBCLC
feeling perplexed in Southern California...

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome