I know this will run the gamut, but this is why I ask. I have always believed that it was very important to get a baby to breast quickly and to not introduce a bottle or formula until after breastfeeding was well established. Common, right?
So, I'm just beginning my OB rotation and the nurses on PP last week where I was assigned were quite adamant that the while idea of nipple confusion was hooey. It didn't really matter whether baby got latched on in hospital, that once mama's milk came in-it would all work itself out if she was really committed. I felt like a bit of a fool espousing my book knowledge (and personal experience, but I'm working hard to not transfer my stuff on others) and working really hard with my mom's b/c they really did not want to supplement.
Is this for real? Have you seen this work out? If a woman is having difficulty initiating BFing in hospital, does it really all fall together after her milk comes in- even if baby has been getting multiple bottles a day? I have truly never heard of it "all working out", just the opposite. More often, I've met women who struggled and gave up when supplementing began so early.
Yes, of course I know there comes a time when baby needs to eat. I'm a reasonable person and not being militant about it at all. I am seriously wondering if I have missed something huge here.
Specializes in NICU, PICU, PCVICU and peds oncology.
My son was born with a lethal heart defect requiring him to be transferred to to a
Level 3 NICU within hours of his birth. He was 6 days old when he was put to the breast for the first time, and then only for a few minutes. For reasons I won't go into here, he was not put to the breast again until he was 15 days old. In the meantime he was both tubefed and bottlefed. When I took him home on day 15, there was no chance that my supply was going to meet his demand. He would nurse until he got really PO'd then I'd top him up with EBM in a bottle. By the time we ran out of EBM, we were in sync and he nursed until he was 8 months old.
Years later I went to work in a Level 2 NICU and worked with many babies who were born before they knew they were supposed to eat to survive. Lots of them were successfully and exclusively breastfed by discharge. It really has more to do with commitment and determination than it does with timing, I think.
The answer to this question is *no* IME (personal and professional). So many of our NICU babies go home breastfeeding. MOst of them have had very interrupted breastfeeding experiences.
I breastfed my first daughter for 11 months. She got one bottle at night, every night, so I could get a small break. Second daughter for 3 years. She had a pacifier 2nd DOL because she NEVER STOPPED NURSING!!! She never took one again, never took a bottle either (which made going back to work @ 6 months for 12 hours shifts really interesting)
The answer to this question is *no* IME (personal and professional). So many of our NICU babies go home breastfeeding. MOst of them have had very interrupted breastfeeding experiences.
Not for me, either. When my babies were born, they were brought to me to feed in the daytime, never during the night. I'm sure they were given bottles in the nursery. My youngest was readmitted at 5 days of age, I was not allowed to breast feed or stay with him.....he came home 3 days later and never took a bottle after that. Eventually he weaned to a sippy cup.
And many of our NICU babies go home breastfeeding, too. Maybe not every feeding at first, but that progresses as they get bigger.
Speaking from personal experience I can promise you that it does not magically work out when mom's milk comes in. My daughter had nipple conf....erm preference. She was given a bottle without my consent or knowledge and it all went down hill from there. My daughter would not latch, would scream and cry when I tried and I cried for hours. I decided that as much as I wanted to breast-feed, it just wasn't worth the way I felt when I tried to get her to latch. I exclusively pumped while home on maternity leave. I stopped shortly after I went back to work because my co-workers were not supportive and I could never get relief to go pump. She seems no worse for the wear for having formula from months 3-12.
I am pregnant with number two and really committed and determined to breast feed successfully this time around. I will not be returning to work because we will be moving a few months after my maternity leave would be finished anyway. I hope that these factors work out in my favor.
I know this will run the gamut, but this is why I ask. I have always believed that it was very important to get a baby to breast quickly and to not introduce a bottle or formula until after breastfeeding was well established. Common, right?
So, I'm just beginning my OB rotation and the nurses on PP last week where I was assigned were quite adamant that the while idea of nipple confusion was hooey. It didn't really matter whether baby got latched on in hospital, that once mama's milk came in-it would all work itself out if she was really committed. I felt like a bit of a fool espousing my book knowledge (and personal experience, but I'm working hard to not transfer my stuff on others) and working really hard with my mom's b/c they really did not want to supplement.
Is this for real? Have you seen this work out? If a woman is having difficulty initiating BFing in hospital, does it really all fall together after her milk comes in- even if baby has been getting multiple bottles a day? I have truly never heard of it "all working out", just the opposite. More often, I've met women who struggled and gave up when supplementing began so early.
Yes, of course I know there comes a time when baby needs to eat. I'm a reasonable person and not being militant about it at all. I am seriously wondering if I have missed something huge here.
There is no proof regarding nipple confusion. I have feed many babies whose mother's "swore" that their child just "wouldn't" go from a bottle to the breast and vice-versa...only to be shocked when shown how easy a baby will make the transition when a nurse or lactation consultant makes a better effort at getting the baby to eat.
You cannot allow for a baby's nutritional needs to go downhill if Mom's milk supply is slow to come in. This is especialy a problem for c-sections because the natural birthing process is interrupted, same thing with inductions, etc.
I have seen a few mothers that naturally go into labor and their milk comes in very quickly as compared to mothers who have "help".
Mom's need to breastfeed and/or pump as soon as possible in order to establish a good milk supply. Breasts product milk on demand...so little to no pumping tells the body that the milk is not needed and Mom risks the milk supply stopping or being drastically reduced.
You've brought up a very interesting point. I read some data recently out of BJM that suggested that labor that were chemically intefered with (pretty much everything I've seen so far in hospital) had higher degrees of difficulty breastfeeding w/the idea being that the natural oxytocin progression and hence, prolactin connection was interfered with. So many things we don't understand.
The more I study pregnancy, birth, and breastfeeding; the more I am convinced we are brilliant, perfectly designed creations that are poorly understood. (Not to begin a theological discussion, but just my heart felt thoughts)
You've brought up a very interesting point. I read some data recently out of BJM that suggested that labor that were chemically intefered with (pretty much everything I've seen so far in hospital) had higher degrees of difficulty breastfeeding w/the idea being that the natural oxytocin progression and hence, prolactin connection was interfered with. So many things we don't understand.
The more I study pregnancy, birth, and breastfeeding; the more I am convinced we are brilliant, perfectly designed creations that are poorly understood. (Not to begin a theological discussion, but just my heart felt thoughts)
My heart sings to hear you say this. I have had 3 babies and been to lots of births as a doula, and by and large, this is true. Yes, there are times when things deviate from "normal" and "perfect" but given the opportunity and most importantly support, lots of women can have that experience* and have such amazing confidence and faith in their body and ultimately in their ability to mother.
*by "that experience" I don't have a particular outcome in mind. Just to feel supported and empowered in her decisions, spills over to the rest of her life. I had two beautiful simple, drug free out of hospital deliveries...and one...well, we'll just say not so much, and I still feel great about it.
Just the fact that you have this attitude will change how you approach a laboring mama. It's a completely different mindset than someone who looks at her like an emergency waiting to happen, a ticking timebomb.
If you're interested in furthering your investigation into our culture of birth, I suggest "Birth as an American Rite of Passage" by Robbie Davis Floyd.
As far as the OP, I know people who claim there is "no such thing" as nipple confusion, but the fact remains that some baby tend to "prefer" the bottle/paci and have a difficult time latching onto mom after those are introduced. Since latch is SO important for effective nursing, bringing the milk in, mom's comfort and thus willingness to nurse on demand, and since we don't know which babies will or won't get confused it's most prudent to avoid it until a good breastfeeding latch is established. For some babies that will be quicker than others (my second child got a paci on day 2 and nursed and nursed and nursed until she was gently forced off at 26 months. :) But I do suspect it has more to do with supply: a baby who is getting bottles at birth isn't at the breast as much, so if mom isn't pumping or otherwise stimulating her supply, the milk is going to be delayed, baby has a longer time period to get used to the bottle. One thing I haven't seen mentioned is that milk from a bottle flows far differently than from the breast. Babies have to work far harder at the breast and once a baby has gotten used to the easier flow of the bottle it can be hard to retrain them to wait.
But...obviously NICU moms and moms who have general anesthesia/cesareans/otherwise traumatic births to where baby and mom can't be together right off the bat, with enough support and committment can and absolutely do go on to have successful nursing relationships. There are just no absolutes. It's great if that immediate bonding, skin to skin happens, but it's not the last ship that sails as far as breastfeeding goes. I look at it the same as bonding in general. Sure, it's fantastic to start that process immediately after birth, but you talk to all the moms at the playground in 5 years and see if the csection or adoptive moms love their kids any less, you know? It's an OPPORTUNITY, but it's not something that is completely essential.
They DEFITNITELY DO NOT just figure it out when mom's milk comes in! With DD I tried to nurse for 5 weeks and she NEVER latched on right. I supplemented her a lot and spent a lot of time bawling about it!
DS I nursed probably 1/2 hour after birth and had a little trouble nursing on just one side, but I've been EBF'ing him for 3 1/2 months now. He's never had a drop of formula. He does switch between breast and bottle without difficulty but he never had a bottle at all until a about 3 1/2 weeks. I wanted to make sure I had bf'ing established with him before trying it.
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NotReady4PrimeTime, RN
5 Articles; 7,358 Posts
My son was born with a lethal heart defect requiring him to be transferred to to a
Level 3 NICU within hours of his birth. He was 6 days old when he was put to the breast for the first time, and then only for a few minutes. For reasons I won't go into here, he was not put to the breast again until he was 15 days old. In the meantime he was both tubefed and bottlefed. When I took him home on day 15, there was no chance that my supply was going to meet his demand. He would nurse until he got really PO'd then I'd top him up with EBM in a bottle. By the time we ran out of EBM, we were in sync and he nursed until he was 8 months old.
Years later I went to work in a Level 2 NICU and worked with many babies who were born before they knew they were supposed to eat to survive. Lots of them were successfully and exclusively breastfed by discharge. It really has more to do with commitment and determination than it does with timing, I think.