>Heather,
> Thanks for your comments, but let me make myself clear, since I
>feel you got me all wrong. I do not go supplementing on the first
>jump. Im refering to failure to thrive and the sort. I think when
>we are all talking it is understandable that we all follow the rule
>for supplementation...
> 1. Mother's own milk
> 2. Mother's expressed milk
> 3. Milk from a milk bank (not available where I live)
> 4. Formula
Thanks, Carmen. No, it wasn't clear that supplementation would
routinely be EBM.
>
> I probably assumed that we all knew this and this is why I
>probably didnt explained myself well. In these cases where it is
>obvious that supplementation is neccesary, it is not wise to tell
>the mother "feed more often" and go home, or you'll definitely have
>a very sick baby.
You have got me wrong, now, Carmen :)
Fixing the breastfeeding has to be a lot more than saying 'feed more
often' - mothers may need quite a lot of support and counselling to
learn how to feed the baby more effectively (improving the way the
baby positions and attaches can be crucial) and actually *how* to
feed the baby more often.
Yes, I do see a place for supplementing with the mother's own EBM,
but it can be difficult for her to get enough EBM to supplement
*every* time the baby has a feed - you could easily be talking about
a total of 15 ounces a day, and this is *very difficult* for the
mother to collect every day.
However, I do see your reasoning in encouraging 'every time' but I
would expect for many mothers, the time spent pumping to collect 15
ounces a day is a real challenge, and I would worry she was spending
more time with the pump than simply holding the baby and feeding
'direct' as often as possible.
>
>
> Like I explain to the many health professionals I teach, we cannot
>generalize about bf. I explain it this way...not all sore nipples
>are due to poor positioning...there could be skin problems, new
>pregnancy, candidiasis, etc. Likewise, the explanations you
>offered me unfortunatelly do not work in all nursing couples...they
>mostly work with well babies.
>
I can certainly see with very sick babies, different approaches are
needed, and I totally agree with you about not generalising.....each
situation needs a tailor made approach, especially when dealing with
babies who already have serious problems.
Thanks for your comments, Carmen.
Heather Welford Neil
NCT bfc, tutor, UK
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