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From:
Katharine West <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Mon, 23 Dec 1996 03:35:48 -0800
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In my experience consulting with many yuppie career-oriented moms who
largely refused cup/finger/syringe feeds and would have quit bf
altogether, I *had* to learn how to help them bottlefeed in the midst of
a bf problem (of many varieties). I will join Diane on her limb with the
caveat that each mom and babe are individually assessed, not only for
the underlying problem but also for the custom-tailored best solution.
I have long ago (8 years or so) been rare among LCs by "allowing"
(sometimes even suggesting - gasp!) a bottle with the following minimal
instructions for its use:
1) Use the bottle at night preferably - quick and fast and everyone back
to bed is the goal; Rationale: Moms cope much better by day with
"teaching" a recalcitrant/problem nurser if she has had sleep by night.
Also Dads are certainly more supportive if he sees his wife managing - I
have seen men be more concerned over their wife's state of mind/energy
than the baby's longterm needs for BM and insist on weaning otherwise.
Baby is more sleepy at night and possibly less alert to the style of
feeding. 2)Use the bottle to "teach" breastfeeding: Hold the baby close
as for bf (and switch arms mid-bottle), tickle the lower lip, wait for
the wide-O, reward the baby with something to suck and swallow (place
the teat on the tongue and let baby close lips to start sucking), watch
for the breathing pause, then tilt the bottle down (without removing the
nipple from the mouth) to stop milk-flow until baby reinitiates the next
suck cycle - I make *sure* Dads and Grandmas demonstrate this technique
to me personally; Rationale: some learning seems to be readily
adaptable, and baby can continue to work on responding to stimuli in a
proper manner. 3) Breastmilk is the best to put in the bottle (Mom might
pump during the day after feeds to create the nighttime stash)(if there
is no BM, then ABM is the only acceptable alternative - ie, don't
substitute glucose H20 or plain H20); obvious rationale. 4) (And
probably the most significant reason for the huge success I have seen
with this radical approach) I instruct parents that newborns "remember"
the latch-on and suck/swallow of the *most recent* feeding (ie the
"last" feeding). Therefore, if Dad gives a bottle at 4 AM and the 7 AM
feeding will be at the breast, baby is going to remember "bottle" not
"breast". So I warn mom about this. I suggest she get baby 15 minutes
early at 6:45 before ravenous hunger hits, and take the extra time to
"re-teach" the breast - first, she can express so the let-down is there,
then she does a brief finger-stim until the suck is right (I teach her
all this), then offer the breast in the usual manner. I remind her that
it may take several latch-on attempts as the baby is literally switching
gears. Knowing this - following a good night sleep - provides infinite
patience and minimal frustration for her. The next feeding (9 or 10 am),
baby "remembers" the 7:00 breast latch-on and usually does better, with
reinforcement continuing through the day. Rationale: Start the feeding
early while baby is still sleepy and/or not overly hungry helps baby get
into a learning mode; telling mom she is a her baby's first teacher
under special circumstances helps boost her confidence; pointing out
*why* the breastfeed after the bottle feed is going to be awkward keeps
the focus where it should be: on a learning infant, not on an
"incompetent mom" (the assumed, and very wrong, conclusion otherwise).
Also, I have used this information approach in the NICU to teach moms to
teach their growing premies to breastfeed and it works extraordinarily
well, considering it may not even be the same-time feeding every day
that baby gets to directly nurse, or that mom will even have a competent
LC nurse to assist her on her next visit.
The result has been, and is, that the moms I consult with are delayed by
2-3 days for total breastfeeding, but with minimal fatigue and - bonus -
their sanity intact. Plus I rarely have to use special feeding equipment
anymore. I think, (emphasis intended) USED THIS WAY, bottles can be a
sanity-saver, and a breastfeeding-saver, for the specific families who
seem to need this approach.
Additionally, picking up on the novice-expert thread, I know my style
conveys enormous confidence that mom can succeed at bf - I have a very
easy-going, relaxed, informational approach, and I ask questions and do
LOTS of listening - most parents and babies will "tell me" what the best
solution is, if I just listen long enough and then re-interpret for them
what they already know, but didn't realize they knew (if you know what I
mean!).
Ever supportive of breastfeeding, Katharine

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