I hear from moms
regularly that are planning on using both breastfeeding and bottle
feeding. Some of them are well informed about the many dangers of
formula and have a pump ready to use to provide expressed breastmilk.
Some are not, and the first place we begin is with a lesson on the
many inadequacies of infant formulas. For the ones that do know
that breastmilk only is the goal, but want their husbands to "bond"
with the baby, our lesson begins with all the many, many ways in
which fathers can interact with their babies without using a bottle.
Regardless of what
is being put in the bottle, there are several areas of impact
that remain the same.
Using an artificial
nipple risks nipple preference.
Nipple preference,
or nipple confusion (though this term is more commonly used, I
don't like it as much, since the baby is obviously not confused
about it at all, but quite clear on their "preference"),
is a serious risk when any artificial nipple is used. This includes
any bottle nipple, regardless of "how like breastfeeding"
it is considered to be by the individuals in charge of marketing
for that company.
A bottle nipple
drips milk out, and with very little effort, a baby can get a
steady flow of milk going. There is no need to wait for a letdown
upon initial "latch." It begins pouring out immediately.
THIS is why the nipple preference is exhibited. Our babies are
very intelligent and even one exposure to a bottle can be enough
for them to figure out that the bottle is faster. This is also
the reason why nipple preference can happen at any age.
Some babies exhibit
nipple preference from one exposure to a bottle. Some babies will
exhibit it after several exposures. Some babies will go back and
forth without any difficulty. Some go for a while without difficulty
and then suddenly show nipple preference. Some babies seem to
do fine going from bottle to breast, but there are subtle problems
hidden in supply issues for mom. Even if EBM (expressed breastmilk)
is being used for all bottles, it can become a supply struggle
for the mother in that a pump will never offer the stimulation
that the baby at the breast will.
Signs of Nipple
Preference
- Compromised
latch that makes mom's nipples sore
- Fussing at the
breast (Hey, Mom, it isn't working fast enough)
- Flailing arms
and legs (this is the "why isn't there milk pouring out"
motion)
- Pushing away
from the breast with hands (this is the "I'm going to MAKE
it come out motion)
- Latching and
unlatching over and over
- Crying and turning
head away
- Outright screaming
and complete refusal to latch
A pacifier can
cause nipple preference as well.
The risk of nipple
preference with pacifier use is less, in that there is no milk
dripping out of a pacifier to make it a tempting option. However,
there are some babies that will happily suck on a pacifier in
the early stages of hunger. This will have an effect on breastmilk
supply. It can cause a compromised latch, which will cause soreness
for mom and potentially effect supply as well.
Use of bottles
affects mom's breastmilk supply.
If mom is using
formula to supplement breastfeeding, she is telling her body,
with every ounce of formula, to make less milk. Her body is not
receiving all the signals it needs to make the perfect quantity
for her baby, if she is interfering with those signals.
If mom is using
EBM, she is still giving her body mixed signals, in that the pump
does not provide the stimulation that the baby does at the breast.
Mothers who have chosen to work and continue breastfeeding, do
so with a serious mission to provide breastmilk for their babies.
It takes a lot of stimulation from baby in the hours that mom
is home to make up for the hours that a pump takes over. It is
very possible to do, and I encourage any mom that is returning
to work to do it.
Breastfeeding
works optimally with feeding at the breast only.
The bottom line
is that the supply and demand system that provides the perfect
amount of breastmilk for your baby works optimally with baby at
the breast. The use of a bottle compromises that perfect system.
Some moms find a way to make it work. Some don't and the breastfeeding
relationship has slipped away from them before they even realized
the source of the problem.
If you are returning
to work, seek out some help from experienced working breastfeeding
moms, La
Leche League and/or an IBCLC to find some alternative feeding
methods and special "tricks" that will help you make
breastfeeding a success.
If you are at home
with your children, there is no need to run the risk that the
use of a bottle is to the breastfeeding relationship.
05/2001 |