>No flames about the nipple shield, please. This baby was so hypotonic 
>and low energy that she really needed to not have to work to keep the 
>breast in her mouth.

For those who, like me, don't often see little premies and other low-energy guys, what Cathy describes is wonderful to see in action.  Without the shield, the suck pattern is:

sucksucksuck - suck - suck - suck - suck - p-a-u-s-e - sucksucksuck - suck - suck -suck -suck - p-a-u-s-e - sucksucksuck - suck -suck -suck...

with each burst of rapid sucks representing the baby having to get the nipple back into position before he can do any long nutritive sucks.  The pauses are inevitable because of fatigue, but every pause must be followed by sucksucksuck.

Add a nipple shield, so that the nipple doesn't slip away during those many rest periods, and the pattern becomes 

suck - suck - suck -suck - p-a-u-s-e - suck - suck -suck -suck - p-a-u-s-e - suck -suck -suck...

The pauses are still there, but all the energy and time of those rapid nipple-gathering sucks is saved for nutritive sucking.  Very cool!

Diane Wiessinger, MS, IBCLC  Ithaca, NY  USA
www.wiessinger.baka.com


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