Pat,

Thanks for reminding us of this concept .  Perhaps this is one of the
reasons why it is hard to accept change.  For example, nurses bottle
feed instead of cup feeding supplements (or using some other alternative
feeding method); or they bottle feed rather than help the mother
breastfeed because they are experts at bottle feeding and novices at cup
feeding.  Maybe they are advanced beginner at breastfeeding.  So what
makes them feel confident and successful?  Bottle feeding.  It gets the
x number of milliliters into the baby that makes the doctor happy and
allows the baby to go home.

Had a mom tell me today that she was disappointed that her premie was
bottle fed before he was breastfed and was being supplemented with
bottles per doctor's orders.  She said the nursery nurse told her she
had never known of a baby who wouldn't breastfeed after having been
bottlefed.  (Groan.)  Couldn't talk the doctor into an SNS although mom
was enthusiastic about the idea.  I think it's a lot this competence
thing again, although it drives me nuts!  I really think this mom will
succeed though.  Baby still breastfeeds well (35 weeker); mom is
assertive, very determined to breastfeed, and has family support.  It
still frustrates me, though, since the bottle is totally unnecessary.
We have policies for every conceivable type of alternative feeding
methods.  Okay.  Time to put away the soapbox!

I think this concept also has relevance to the suctioning discussion.
If we throw out our current guidelines, that moves us back on skill
level by at least a couple notches.  We now have to think through
situations that have been automatic for years.  This is hard!  Some of
us like to be on the cutting edge.  We thrive on change--reading the
latest ideas and then applying them.  We don't understand why others
don't follow--I know I don't.  Yes, I understand in theory, but I don't
understand emotionally.  I'll keep trying.

--
Bonnie Jones, RN, ICCE, IBCLC
from the sunny S.W. USA
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