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Subject:
From:
Judy Fram <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Fri, 11 Apr 1997 11:23:04 -0400
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Sorry I forgot the first "T" in LACTNET, so this may not have gotten to the
list. If it did it's the same as before, so scroll away... Judy Fram,
Brooklyn, NY
---------------------
Forwarded message:
Subj:    When to intro a bottle-long
Date:    97-04-11 10:47:59 EDT
From:    AgentJaye
To:      [log in to unmask]

I have several comments about the post from Carol S> about when to introduce
a bottle to a BF baby. First I have to say that I've tried to access this
from the archives to have the actual words in front of me but could only find
Carol Bs post, which I had no problem with. If I misquote something I
apologize.
     If a baby is "1,2,4,or 6" weeks old , then it may happen that we are
telling a mother that it is OK to intro a bottle to a 1 or 2  week old baby
just because for the FIRST time the baby had been "latched on and you won't
remember putting him there...That's the day (when you have both gotten so
'good' at bf that it doesn't take any conscious effort on your part) to
introduce a practice bottle."
     I have a few concerns about this statement. If we intro a bottle the
first time this easy/automatic latch occurs then we have not "established
successful BF". To establish means to make permanent, stable or secure
according to Webster, and doing something (no matter how easily and
subconsciously it is accomplished) for the FIRST time does not mean it is
"established" By definition established means stable, and this means over a
period of time, not in one instance. This baby could still go on to become
nipple confused and this is not something to risk lightly. The other problem
I have with introducing a bottle the first time, or even very soon after, BF
seems to be going smoothly is this: bottle feeding is not a refinement or
progression of nursing at the breast. It only makes sense to move from breast
to bottle in rapid succesion if these skills themselves are related, building
blocks or refinements, but they are not. Although both are feeding skills,
they are very different in timing, muscle use and coordination, and at times
they can be contradictory as in the case of proper tongue participation. Why
would we teach our children to wheel a wheelchair simply because they've just
learned to ride a bike?
     Why do women need our "OK to consider leaving the baby with a bottle of
milk instead of her on occasion?" We provide moms with the information they
need, if they want to go out we explain the options on how to go out. If this
is a baby who is not "out of the woods" in terms of what we know about nipple
confusion, we tell her in a sense it is not OK (without risk) but if she
chooses to do it we help as best we can to prevent problems. We offer
choices, delay the outing, take baby with you, take caregiver along to watch
baby between feeds, use alt, feed methods, use Avent (or whatever your
experience tells you to suggest), or give possible indicators  to look for
possible NC if she goes out anyway. She doesn't need our permission, only our
support and our knowledge.
     Why do we suggest to intro a bottle simply because "the fun part of
nursing" has arrived? What's about finally taking the baby out with family
for dinner and enjoying being able to nurse discreetly in the restaurant?
Isn't that what the fun part is, having gotten to the stage where nursing is
easy and natural and non-confining - when we don''t need to sit on the couch
with two pillows and our shirt off to watch every attempt the baby makes? We
need to remember that this is a bottlefeeding culture and when we suggest
that she will want to intro a bottle, we are not being fair.,Stepping back,
asking open-ended questions about her plans in the upcoming weeks and months
gives her the chance to decided if SHE want/needs this baby to take a bottle.
We can provide anticipatory guidance on how family members can be involved
and helpful, including burping, bathing, snuggling, carrying, feeding Mom,
changing diapers and choosing clothing, and the eventual intro of solids- an
"honor bestowed" on my mother-in-law. Just because a relative makes noises
about wanting to do something ( bottlefeed ,in this case, or offer solids,
have a sleepover, buy a toy gun,etc.) doesn't mean the mother has to say yes.
Sometimes she will delay sometimes she can say no. We are empowering her to
make her own choices based on good information. Since new mothers can be so
fragile, we need to be sure that our suggestions about the "best "time to
intro a bottle do not erode the mothering style she is cautiously building,
which may not have included bottlefeeding as a necessity. If we assume she
wants to use bottles, we do her a disservice. Perhaps you only have this
discussion after you ask the open-ended questions, and offer all the
appropriate, individualized options.
    I am glad when mothers are able to alternate breast/bottle early and
without longterm problems if they need this option, but it is only
appropriate to tell moms that MOST babies cannot do this at one or two weeks
of age,.Since they don't come with labels designating "easily
nippleconfused"or "NC Resistant" isn't it best to err on the side of caution
as much as possible? Every woman working with BF moms has a great
individualized bag of experinces to share. I am interested to hear other
opinions/experiences on this subject. Do you think there is anything to the
idea that an LC who recommends bottles earlier also gives a mother confidence
to work out any minor flags of NC after intro of a bottle at 1 or 2 weeks so
that even if it seems to be happening it never spirals out of control and
becomes problematic? This is a phenomenon worth exploring.        Judy Fram,
Brooklyn, NY

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