Susan Johnson wrote:
"Attitude is often the biggest obstacle to change.
 Certainly we have enough research by now to suggest a
 different protocol for feeding NICU babies.  So what's
 the problem?"

The problem really is attitude. Mothers of babies in NICU's will often do things they never thought they would for the sake of their babies. They may hang on every word they hear from a nurse or neonatologist (which certainly can make it hard for HCP's who realize how much a situation can change from moment-to-moment). The point is that HCP's are in a position of power and authority, whether intentional or not. Simply by virtue of their attention to, or negligence of breastfeeding, they deeply influence parental choices. If we remember how open mothers are directly after giving birth (rightly so, since they are in a hormonal learning and attachment mode), the attitudes conveyed in those first hours may not be reversible. It seems to me that if we are going to act conservatively, we would always ask a mother of a baby in NICU to breastfeed as a medical necessity. As a matter of fact, I cannot even see how providing breastmilk can legitimately be viewed as a feeding choice in a !
very premature baby, since feedi
ng really isn't even an option in the traditional sense at this point. Feeding "method" becomes a choice once the baby can eat. Until then, we are talking about a medical food, which is of infinate importance from day one.
Jennifer Tow, IBCLC, CT, USA

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