I'm happy to be back on LN after a long period of "abstinence" from my
drug of choice :-) to enable me to focus on another project, so will
re-introduce myself. I am retired after four and a half decades of
maternity nursing and now volunteer part-time as an IBCLC at our local
WIC project. Decades ago my 6 children provided me with a broad spectrum
of infant feeding disappointments, errors, and satisfying experiences,
which is part of the reason I'm still out here promoting the cause.

Nancy Mohrbacher wrote: "You know how we as adults are told that it is
healthier to eat slowly so that our 'appetite control' mechanism kicks in
before we overeat?  This also applies to babies.  When babies breastfeed,
they develop healthy eating habits.  They tend to take small amounts at
feedings and feed
more times per day.  Newborns breastfeed an average of 8-12 times per
day.  Bottle-feeding, on the other hand, whether it is human milk or
artificial milk in the bottle, sets up an 'overfeeding habit.' . . . .
Some researchers believe that the habitual overfeeding the bottle
promotes contributes to obesity later in life."

IME, you are right on, Nancy. How beautifully and tactfully and
powerfully put! You do 'Weissingerize' well! Parents don't know about
pacing bottle feeding. For that matter, neither do many professionals in
hospitals and doctors offices. Nor grandmother, aunts, babysitters and
daycare providers in general. They say "Look how hungry he was" and "See
how greedy she is" as they watch the frantic chugga-lugging of the
bottle.

They don't recognize it as a stressful, struggle to coordinate breathing
and swallowing, (somewhat akin to that of a baby coping momentarily with
overactive MER). Overfeeding becomes very common. One wonders whether it
isn't a common contributor to the diagnosis du jour GERD. It is often the
straw that breaks the camel's back for the mother who has little support
and little confidence in her ability to satisfy her baby at the breast
and who is yearning for a little predictability in her life. She begins
to prefer seeing her baby fall into a long torpor after she watches a
significant amount of EBM or formula rapidly disappear out of a bottle.

While shopping yesterday, out of curiosity I stopped and read the claims
on the labels of the myriad types of artificial feeding nipples now on
the market. Not only is the old chestnut still being preached that "x
kind of nipple will keep your baby from swallowing air", but all kinds of
shapes are being touted by using the terminology of breast feeding, (wide
base, latch, etc.) to convince the confused buying public to select their
brand. Slow flow nipples are labeled as if solely for newborns.

I repeat the explanation of the need to pace bottlefeeding literally
dozens of time a month. I am thinking seriously of writing a simple
hand-out for our facility cautioning about the syndrome, which I see as
just the tip of the iceberg as far as  'nipple confusion' goes. I find
that flow rate confusion, overfeeding, breast rejection and inadvertent
weaning are often amenable to change, if only the parents are forewarned,
and can get their baby's caregiver to understand and cooperate.

K. Jean Cotterman RNC, IBCLC
Dayton, OH, USA

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