>> I've had babies with strong sucks pull the milk out of a periodontal
syringe without my pushing on it.  But what is the difference between that
and their sucking the milk out of a nipple chamber?  Is there a
difference? Neither is like breastfeeding.<<

Barbara, these are questions that I wrestle with every time I have a baby
requiring supplementation. Some babies don't seem to get messed up, while
others are so sensitive! Bottle feeding is usually perceived as easier
than finger or cup feeding, and so I must assess the mother for her
willingness to carry through when I recommend alternatives that are
contra-cultural.  The one part about the bottles that seems "worse" to me
is that a baby may often resort to drawing his tongue back to control the
flow, and thus may use it minimally in as far as the normal peristaltic
wave for breastfeeding is concerned. When I fingerfeed a baby with a
p-syringe, I control the bolus for the most part (yes, I've had some of
those strong suckers, too!), and I can feel and encourage that tongue to
come forward and "work" for food. Fingerfeeding does provide feedback on
what is going on in baby's mouth, whereas you know very little with the
bottle. They can get hooked on both, yes---- but I have more confidence
in the "training" that can be provided by the fingerfeeding experience vs
the bottlefeeding....

I had a little girl in here this morning, 2 wks old, never gone to breast
and mom never pumped. Mom has "flat" nipples, and I would have been able
to get baby to breast except that the milk supply was almost nil and baby
required her "reward" of milk. She was also trying to "bottle feed" on
mom... and so, after discussing bottle vs finger with the parents, we
agreed on and taught fingerfeeding. I will often see a baby start out
with those characteristic bottling such motions, and then gradually move
to using the tongue more with wider jaw excursions.

I would also add that I try to never say "never", because there are
exceptions to everything in this field! These are just my generalized
observations and conclusions to date...

-Lisa

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Lisa Marasco, BA, LLLL, IBCLC
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