Denny wrote me to ask if I don't think the bottles/supplementation create
the problem. No. The feeding problem pre-dates the exposure to the bottle
(ie the babies are preemies, in the case of her twins). By the medical
definition coined by Lawrence, Neifert and Seacat in their article on the
subject in J Peds, 1995...."The term should not be applied to situations in
which a newborn infant displays a primary inability to suckle the breast
effectively, without prior exposure to an artificial teat such as a bottle
nipple, pacifier, or adult finger."
I work with babies every day who have been bottle fed for weeks. It is
very easy to get these babies to breast. You first hypnotize the moms to
stop
believing in nipple confusion. What good does it do for them to believe in
it? That is what makes them wean. They believe its all over now because
they gave bottles, plus they're dying of guilt because their choice was
starve baby or supplement. It's unbearable. Of course you don't give
teats cavilierly in the early pp. That's a sensible rule for the normal
baby,
but none of the babies we're talking about (the ones whom the discharge
nurse
or LC should have red flagged) are normal. Think about the issues Kay James
talked about. These kids are high tone or low tone or immature or ill or
injured. Or mom is a poor physical fit, or is ill or surgically affected or
hysterical. Everyone blames the bottles instead of the dysfunctional baby
or the poor milk exchange.
If the mom has breast which are full of milk, had nipples baby can grasp,
and if both have finally recovered from the delivery or the prematurity or
the illness/injury, all you do is get mom naked in side-lying and feed baby
a couple of good swigs of milk so it isn't hungry, and let them crawl to
the nipple. Sometimes I sandwich it up and tickle their lip a min. or use
a
shield, or drip some milk into their mouths for a min or two to encourage
them, but then they latch and take a few sucks. That's the start. Remind
mom that nursing is PT for the oral structures, which are weak from not
nursing and have to tone back up.
If baby still can't nurse at 2 weeks down road, baby still has a prob. or
nipples are still not graspable (tight, too large, functional retraction,
low milk reward). Keep feeding baby, keep protecting milk supply, keep
doing nuzzling and licking and practicing at most feeds when baby isn't
hungry. Sooner or later they'll usually nurse. Never give up, and prepare
mom that some babies won't nurse till due dates or when they recover from
cephlahematomas or forceps bruises or clear all meds. Not a prob. I tell
them. Just keep doing 1,2, and 3 and baby will go.
We prime moms to fail when we blame the supplemental methods instead of
the baby's inability to feed normally. I disagree that most of these
babies
were feeding well before supplementation. They were TRYING VALIANTLY to
feed, but because nothing was happening they gave up. If not supplemented
they would starve. They are not CONFUSED by bottles, etc. just grateful
and making the smart survival choice. Make breastfeeding work as easily and
why wouldn't they nurse? They are hardwired by a zillion years of
mammalian
evolution to prefer it. That is my belief system and I find that having
this as my dogma results in a high level of success transfering everyone
back to
bfg. which is always my goal and is typically the way these cases resolve.
Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.jump.net/~bwc/lactnews.html
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