finger feeding

babynurselsa, RN · Mar 31, 2006

That was always my thought also.

When I first started NICU 10 years ago and kept seeing the order for finger feeding on the admit orders on kids that came over from Nursery. I finally asked someone one day what it was. When they told me I thought they were trying to feed me a line to see of I would bite.........Imagine my suprise when I discovered they weren't kidding.

RNmommy · Apr 1, 2006

We used to do a lot of finger feeding. Due to numerous readmits for hyperbili, we stopped teaching it. If MOB is breastfeeding, she has two choices, tube at breast or bottle. If she chooses to sabbotage her own breastfeeding with supplements in the nursery so she can get sleep, bottle it will be. If MOB is really dedicated to BF and she is ordered to supplement for weight loss or hyperbili, she should be tube at breat feeding. She is not helping herself or the baby with doing feedings away from the breast.

jrring1019 · Apr 2, 2006

We used to do a lot of finger feeding. Due to numerous readmits for hyperbili, we stopped teaching it. If MOB is breastfeeding, she has two choices, tube at breast or bottle. If she chooses to sabbotage her own breastfeeding with supplements in the nursery so she can get sleep, bottle it will be. If MOB is really dedicated to BF and she is ordered to supplement for weight loss or hyperbili, she should be tube at breat feeding. She is not helping herself or the baby with doing feedings away from the breast.

I think that is harsh. If mom chooses to supplement because she is tired then so be it. I am one of those moms that sent the baby to the nursery for the night.How many moms have you seen crying and exhausted in the middle of the night because they think that they must nurse 24/7 after spending a day in labor? Give them a break! It is better for mom/baby/milk production for mom to go home at least slightly rested...especially if she has other little ones at home!

How was finger feeding related to hyperbili??

RNmommy · Apr 2, 2006

I wasn't trying to be harsh, I'm being realistic. All of our current research tells us that rooming in, responding to the baby's early hunger cues and feeding on demand are most supportive in establishing an adequate milk supply. Cluster feeding is a natural part of that process. Bogging a baby down with uneeded calories so it will sleep and so mom gets some sleep is not "best" practice. I have found that offering mom emotional support in the middle of the night has helped a lot more than artificially feeding the baby. I work NOCS. I am faced with this almost every night. Babies can go to the nursery between feedings and do not have to be supplemented for mom to get a little rest.

I have yet to see a baby who has spent a day in labor feed "24/7". In my experience, after the first 4 hours or so, you can't beg a baby under 24h to wake up to eat (not all babies, but the majority).

I refuse to concede that formula feeding for mom's rest is beneficial to breastfeeding. It is not.

Basically, the problem we were having with fingerfeeding was that babies were being discharged with fingerfeeding being their only method for getting food. These babies were not increasing their intake and after 4 or 5 days would still only be taking 20cc per feeding. They got dehyrdated and became extremely jaundiced. After lots of complaints from our peds we started cutting way back on fingerfeeding. Now, it's tube at breast or bottle for supplements. Tube at breast should always be the first choice.

Lastly, if fingerfeeding is faster than bottlefeeding, you must be pushing the plunger. Otherwise, it should take longer because baby will get less per suckle from a 5F than from an artificial nipple.

jrring1019 · Apr 3, 2006

I mean finger feeding is faster than syringe/cup feeding. Not bottlefeeding.

If babies were only taking 20 cc at 4-5 days of life, then something was lacking in d/c teaching and follow up care.

And so moms are not given a choice to have babies syringe fed in the nursery? If you want your baby supplemented for you to sleep, then its bottle or nothing? If baby has good latch, then bottlefeeding may be ok, but if the kid is still trying to figure it out than introducing an artificial nipple may make them less likely to really work hard at BF. Why are we so type A when it comes to BF?

I have cared for many women of different cultures who don't BF at all until the milk is in and then go on to still successfully BF.

GooeyRN, ADN, BSN, CNA, LPN, RN · Apr 3, 2006

What if baby will still not latch (even after working with the LC) after 24 hours but mom does not want to give up on BFing? Baby has to get nutrition somehow. A tube at the breast will not help this situation. Finger feeding uses a tongue motion similar to BFing, unlike bottlefeeding. It will buy mom and baby a little more time to work on getting the latch issue worked out w/o sabbataging their efforts by introducing an artificial nipple.

Mimi2RN, ASN, RN · Apr 4, 2006

As far as I'm concerned, finger feeding is something for parents to do, if they choose. A mom that wants to sleep needs dad or someone else in the room to care for the baby through the night. Mom really needs the stimulation of frequent latching. We don't have a newborn nursery, and babies are expected to room in. A poor feeder baby may have something else going on.

We don't finger feed in our NICU, and we like moms to come in to nurse as much as possible, when we have term babies admitted. Baby and mom both need to learn what to do.

It's interesting how some moms refuse to nurse at first, and start when the milk comes in. Those babies usually have no problem switching over.

RNmommy · Apr 4, 2006

And so moms are not given a choice to have babies syringe fed in the nursery? If you want your baby supplemented for you to sleep, then its bottle or nothing? If baby has good latch, then bottlefeeding may be ok, but if the kid is still trying to figure it out than introducing an artificial nipple may make them less likely to really work hard at BF. Why are we so type A when it comes to BF?.

Basically, yes. It is not type A. A breastfeeding newborn shouldn't be supplemented unless medically indicated. If the baby doesn't have a good latch, that is EVEN MORE reason to encourage MOB to do all feeds at the breast, not offer a supplement. When our moms are given all of the tools and education to make their choices, most often they choose not to supplement. We rarely supplement babies strictly for maternal rest.

I, too, have seen women bottlefeed until their milk comes in then switch back to breast without any problem but this situation is counter to all of our currently available research. There have also been lots of babies put to sleep on their tummies and survived. I'm not about to support that, either.

tinyscrafts · Apr 5, 2006

yup That's blunt, but totally accurate IMO.

Moms get more sleep when they sleep with their infants anyway.

The colostrum gets the mec out and decreases jaundice. If supplemented, it's usually w/ artificial formulas

LilPeanut, MSN, RN, NP · Apr 5, 2006

I had to finger feed my son when he came home from the hospital (born 34w, d'c'd @37w) because he wasd nipple confused and as a preemie, letting him miss any meals wasn't an option. We were very careful about it and literally, if he wasn't on the breast trying to nurse, was getting fed it seemed. We kept a very close eye on his input to make sure that he was getting adequate amounts. He ended up figuring it all out within 2 days and without finger-feeding, I doubt he would have nursed.

cammy429 · Apr 5, 2006

excuse my ignorance but since I have NO experience in this area as yet can someone please explain further, in layman's terms what finger feeding is and how it is done.

Thanks

Can anyone tell me the difference between finger feeding and bottlefeeding? Honestly, my gloved finger+feeding tube +formula would seem the same to baby as a artificial nipple....Right? I always abide by moms wishes and only supplement if requested and by the means requested but finger feeding is what is mainly used where I work now. It is much faster, which makes a difference when I have a nursery full of supplemented babies on nights. I would say about half of the BF moms send the baby to the nursery for the night to be supplemented.
Where I used to work we were NOT supposed to finger feed. One of the LC's stated it was related to failure to thrive. We could only cup or syringe feed or do feeding tube at the breast.