What is your hospital's policy on supplemental feeding?

SmilingBluEyes · Nov 10, 2004

I myself do not subscribe to the concept of nipple confusion. I see babies either get it or not....for some it just takes longer, but once they are breastfeeding well, you could stick a vacuum cleaner hose in their mouths and they will suckle on it. I really don't buy this concept at all.

mitchsmom · Nov 10, 2004

an extension of what Kerry was saying... & not saying this necessarily applies to anyone here, but I have found that some nurses don't believe that nipple confusion exists b/c it doesn't happen on their watch. Problems often show up after mom gets home, especially since mothers are usually only at the hospital 48 hours. Sometimes they are very subtle and build over time. Now, whether we can definitively say that it's nipple confusion or not, we may not know for sure (although there are obvoiusly strong opinion on the matter).

I guess my thoughts on it are this: I just hope that people can be very wary in the decision to introduce the bottle to a young baby when there are other viable options, whether they personally believe in it or not, just to err on the side of caution, just as we would with any other questionable or debated practice. Until we can definitively say one way or another. We don't base medicine on what we personally believe, right? Use evidence-based practiceds or err on the side of caution, right?

I do think your experience with the Chinese mothers is interesting, though, fergus. Perhaps they have more success overall because nursing is still generally the norm in their culture? (places/countries where nursing is the norm don't experience as many problems as women in our culture, where we have kind of lost the "art of breastfeeding" as just the normal option for everyone). Maybe there are confounding factors.

PS... I don't know if I believe it per se or not...

SmilingBluEyes · Nov 10, 2004

That's not proof, that nipple confusion exists anymore than my seeing hundreds of babies go back and forth without difficulty is proof that it doesn't exist. Nipple confusion (or nipple preference) is a theory. Some nurses believe it 100%, I'm just not one of them. I should say that I don't think it exists nearly as much as people would have us believe. It seems like every person who has trouble breastfeeding will blame it on nipple confusion if the baby sucked on a pacifier for 3 seconds. I don't give breastfeeding babies bottles, but it isn't because I believe that one bottle will lead them to give up the breast. Some babies will prefer one breast over the other. Some babies won't take to cup feeding. That's just individuality.
Personally, I think a lot of the reason we have so much trouble with breastfeeding in our society is that we have turned it into such a high stress event. The fact that many babies have trouble accepting bottles can just as easily proove that breastfeeding is easier for them, not that they get so confused that they can't do both. Like I said, the asian moms I had never had this kind of difficulty and I think a lot of it had to do with their confidence that breastfeeding is a completely natural event. They weren't so worried that their baby wouldn't learn to breastfeed if they didn't do everything perfectly from the moment the baby was born. I can't tell you how many times we tried to get these women to breastfeed from birth.

Brilliant post. You said it better than I. We really need to DE-medicalize and relax about BF. It's been done for 1000s of years w/o our "interventions" after all. Our attitudes as nurses, and those of our moms (are they TRULY committed to BF)--- have so much more to do with success or failure here, than so-called nipple confusion ever will. I really think we overdo it sometimes.

mitchsmom · Nov 10, 2004

lot of it had to do with their confidence that breastfeeding is a completely natural event. They weren't so worried that their baby wouldn't learn to breastfeed if they didn't do everything perfectly from the moment the baby was born.

That's kind of what I was trying to get at in my post :)

Since we've lost the "art," the whole thing is turned into a big issue instead of just the norm.

fergus51 · Nov 10, 2004

I really believe that mitchsmom. We have medicalized breastfeeding as much as we have medicalized childbirth. Expectant moms come in and they've read about nipple confusion, poor latching, jaundice, inadequate milk supply, and every other possible problem they could have. At the same time, they've been told that breast is best and they should all be able to exclusively breastfeed or they are failures as women. Then when the baby doesn't just jump on the breast and suck perfectly at the first feeding they start stressing.... and stressing.... and stressing. Self fulfilling prophecy is the way I would describe it.

Those Asian mothers could not be scared into thinking that bottle feeding would wreck their chances of breastfeeding (and trust me some of the nurses tried to convince them!). They know they can do it, they have seen their mothers, sister, aunts and friends do it. They know that breastfeeding is not something you need a degree from MIT to do.

fergus51 · Nov 10, 2004

Oh, and like I said, I don't give bottles to breastfeeding babies. They don't need them.

SmilingBluEyes · Nov 10, 2004

Nor do I. Breastfed babies need to do just that. Breastfeed. And I tell their moms that too. I just wish all moms were committed to it-----------some obviously dont' want to, but are just doing it to keep "someone" off their backs. Sometimes, I have to ask them outright (privately) if it's truly what they want to do----and sometimes the answer is NO. We have to respect that choice, as well.

klone, MSN, RN · Nov 11, 2004

I should say that I don't think it exists nearly as much as people would have us believe. It seems like every person who has trouble breastfeeding will blame it on nipple confusion if the baby sucked on a pacifier for 3 seconds.

Oh, if that's your position, I totally agree with you. I mistakenly thought you were dismissing the idea of nipple confusion 100%. I agree with you that it's OVERemphasized as a problem. I do believe that MOST babies will be just fine going from breast to bottle, and that bottles are a viable option in many cases. I also believe that "confusion" or "preference" can happen with ANY feeding method, and that using a cup or syringe doesn't preclude this problem from happening.

mitchsmom · Nov 11, 2004

sorry if I'm beating a dead horse just when we are all getting along so nicely ...

just wanted to add that something else to consider is: -for whatever reasons OR confounding reasons that may be contributing- studies have found that babies who have artificial teats/pacifiers breastfeed for a shorter duration overall .

a bunch of references and pages w/ more info just in case anyone is dying to read more about it, LOL:

http://www.kellymom.com/bf/start/concerns/pacifier.html#bfstudies

http://www.kellymom.com/bf/start/concerns/pacifier.html#confusion

And I totally understand that the whole thing just isn't the choice for some people... and in my bf counselor life I ONLY help peole who come to me for help. Here on this forum I may go on about it a lot, because it is one of my big interests and because I feel I can learn from the L&D nurses here, but I never ever badger pregnant and bf moms... I am plenty busy with just the ones that are seeking my help! It's a choice people have to make for themselves, just like anything else.

klone, MSN, RN · Nov 11, 2004

And I totally understand that the whole thing just isn't the choice for some people... and in my bf counselor life I ONLY help peole who come to me for help. Here on this forum I may go on about it a lot, because it is one of my big interests and because I feel I can learn from the L&D nurses here, but I never ever badger pregnant and bf moms... I am plenty busy with just the ones that are seeking my help! It's a choice people have to make for themselves, just like anything else.

Ditto what Mitch'smom said. :)

fergus51 · Nov 11, 2004

I have read a lot of those studies. In my experience they tend to ignore other issues that I would consider important. Like how many women in the family also breastfed, and for how long? How supportive were the fathers? How long did they have off work? How many other children did they have at home? What were their previous experiences with breastfeeding? How would they rate their own patience and confidence level? How strongly did they want to breastfeed in the first place? They present theories and I think it's important that we acknowledge there is a difference between theory and fact, just like there is a difference between correlation and causation.

In my experience, women who want to breastfeed and have the proper support will. Women who aren't sure or don't really want to will pretend they want to breastfeed and then won't do it and we'll say it's because of pacifiers or bottles regardless of how supported they were. I'm one of those people who thinks the answer is usually simpler.

SmilingBluEyes · Nov 11, 2004

I have read a lot of those studies. In my experience they tend to ignore other issues that I would consider important. Like how many women in the family also breastfed, and for how long? How supportive were the fathers? How long did they have off work? How many other children did they have at home? What were their previous experiences with breastfeeding? How would they rate their own patience and confidence level? How strongly did they want to breastfeed in the first place? They present theories and I think it's important that we acknowledge there is a difference between theory and fact, just like there is a difference between correlation and causation.
In my experience, women who want to breastfeed and have the proper support will. Women who aren't sure or don't really want to will pretend they want to breastfeed and then won't do it and we'll say it's because of pacifiers or bottles regardless of how supported they were. I'm one of those people who thinks the answer is usually simpler.

Stated perfectly. Thank you.