The nipple confusion controversy goes on and I feel that both sides have
valid points to offer. When faced with a baby who can't or won't suckle at
the breast, we will try just about anything to teach him. At our hospital
there is a policy that no breastfed infants receive any artifical
nipples(unless mom requests or we have come to that stage in the game) We
feed our babies either by gavage, finger feeding or cup feeding and this
usually works quite nicely while we wait for the baby to "come around".
Mothering the mother is very important as this is a major problem for her
and it is difficult for her to see the "light at the end of the tunnel". We
have a special room we call the Care by Parent room, and mom can stay here
(overnight with meals included) as long as she needs intensive hands on
help with breastfeeding. If she prefers to go home, a service is provided 7
days a week to check in on her at home.
        One of the common problems that I see with these babies is that they
quickly become frustrated if their efforts aren't instantly gratified as
with an SNS or finger feeding. ( even if mom has lots of milk )Does anyone
have any ideas on this?
        Sometimes we do resort to using a NUK nipple to help teach the baby to
suck/swallow and this has worked .(we do on occasion break the "rules")
        We have a 20% c/section rate and it is only these moms who receive
epidurals and thus usually only these babies who have this problem.We have
noted that on weekends and off hours, the babies often do better and we are
starting to relate it to the fact that recovery room sends moms back to the
floor faster during the off hours.
        I don't think that we will ever stop the medication, but perhaps we can
put all babies to the breast in the recovery room.Wish me luck!