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Re: Bottle First??

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How do you all feel about that handout by Smillie? It is perplexing to me. Other than anecdotal, has there been any research to document successful breastfeeding following bottle first supplementing?

I think the thought is intriguing. I'd like to try it with some moms, and see what happens. I'm certainly not of the opinion that this will work for every mom, and I think we need to evaluate this tool just as we would any other tool. Don't NOT use it just because at this point it is not "evidence based", but don't jump on it as the answer to every low milk supply problem either. Be judicious and evaluate it carefully.

I'm going to try it with some selected moms and see what happens.

Jan - at the ILCA conference listening to Donna Ramsey about milk removal...

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Boy, I felt

the same way when I read it. Something just doesn’t seem right with

it. I agree with Jan that it bears some investigation, maybe even giving

it a try with a mom or two, but I tell moms that every ounce the baby gets that

doesn’t come from the breast, the breast doesn’t know it needs to

make, unless you pump instead. I think I got that from Hartmann’s

day long session before the Boca conference ?! I will say that I have

used a variation of this protocol when a baby has had several bottles and is

screaming hungry and unwilling to take the breast, where mom gives the baby a

little from the bottle to take the edge off, but I have never employed it as a

strategy to increase supply without pumping. I’d be interested to

see some case studies.

Marsha

~~~~~~~~~~~~~~~~~Marsha Glass RN, BSN, IBCLC~~~~~~~~~~~~~~~~~~~~~

Mothers have as powerful an influence over the welfare of future

generations as all other earthly causes combined.

~~~~~~~~~~~~~~~~~~~~~~~~~ S. C. Abbot~~~~~~~~~~~~~~~~~~~~~~~~~

How do you all feel about that handout by

Smillie? It is perplexing to me. Other than anecdotal, has there

been any research to document successful breastfeeding following bottle first

supplementing?

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This is interesting. I'm working with a mom now who

pretty much decided to do this on her own. Except

that she is still pumping after feeds. It wasn't what

I recommended, but she told me that was what she

wanted to do, so that is what she is doing. I did

suggest to her that she taper down the amount that the

baby got by bottle before going to breast. She told

me that when she started with the bottle, he was more

interested in the breast. Go figure. And she had

also decided on her own that she wanted her baby to

finish at the breast and learn that he could become

full there. I had to admit it made some sense. I'll

be following up with her tomorrow and I'll give you a

case study if possible.

Regards,

Cindi Swisher, RN, IBCLC

Alliance Breastfeeding Center, LLC

http://www.nursingzone.com

--- Marsha Glass wrote:

> Boy, I felt the same way when I read it. Something

> just doesn't seem right

> with it. I agree with Jan that it bears some

> investigation, maybe even

> giving it a try with a mom or two, but I tell moms

> that every ounce the baby

> gets that doesn't come from the breast, the breast

> doesn't know it needs to

> make, unless you pump instead. I think I got that

> from Hartmann's day

> long session before the Boca conference ?! I will

> say that I have used a

> variation of this protocol when a baby has had

> several bottles and is

> screaming hungry and unwilling to take the breast,

> where mom gives the baby

> a little from the bottle to take the edge off, but I

> have never employed it

> as a strategy to increase supply without pumping.

> I'd be interested to see

> some case studies.

>

> Marsha

__________________________________________________

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Yes, I've seen this work. It can happen that the baby has no patience

to wait for the MER and gets so upset that he won't nurse at all. An

ounce of EBM to take the edge off his hunger can do wonders.

Even when it works, it's not something I recommend for every feeding.

I teach the mother to read her baby and go with what he's telling her.

If she can offer the breast before the baby gets hungry, he may have

the patience to wait for the MER. If he's already hungry, he may not.

- Bloodgood, IBCLC

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Hi, everyone,

I am very behind, having just returned from three weeks away, but I

wanted to chime in on this interesting question of bottle or breast

first. I have heard Tina Smillie talk about the

" Bottlefirst " concept and have used it with my clients with

excellent success. My co-author Marasco and I introduced it in

our new book " Making More Milk " (due out this fall). We

spent a LOT of time scrutinizing the rationale and talking in great depth

to Tina about her philosophy. We concluded that it made a lot of

sense physiologically, but we did add an explanation in our book that

lays out the rationale in more detail than Tina's handout has room to

do. We are convinced that it will become the new paradigm in

supplementation because it simply works and is more physiologic.

Let me know if you'd like to read our explanation.

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I think this makes a lot of sense in a situation where the mother is already using bottles to offer supplements to her baby as a way to transition back to exclusive breastfeeding, but I don't think I would ever suggest it to a mother who has not yet used a bottle. There are too many potential pitfalls to using a bottle, and the lactation aid offers the same benefits as the "bottlefirst" method, without these pitfalls. I would think even giving the baby a bit of milk by cup prior to going to the breast would achieve the same results as this method.

Dupras, IBCLC,, RLC,, Doula, Student Midwife

Laval, Quebec

www.mamadearest.ca

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I also wonder if offering the breast more often would work well. I often tell mothers to nurse more often so that the baby isn't "ravenously hungry" when the breastfeeding begins.

Emery, RN, IBCLC Dupras IBCLC wrote:

I think this makes a lot of sense in a situation where the mother is already using bottles to offer supplements to her baby as a way to transition back to exclusive breastfeeding, but I don't think I would ever suggest it to a mother who has not yet used a bottle. There are too many potential pitfalls to using a bottle, and the lactation aid offers the same benefits as the "bottlefirst" method, without these pitfalls. I would think even giving the baby a bit of milk by cup prior to going to the breast would achieve the same results as this method.

Dupras, IBCLC,, RLC,, Doula, Student Midwife

Laval, Quebec

www.mamadearest.ca

--No virus found in this outgoing message.Checked by AVG Anti-Virus.Version: 7.0.323 / Virus Database: 267.8.15/49 - Release Date: 14/07/2005

Wysocki-Emery, RN, IBCLC

2505 Ardmore SE

Grand Rapids, MI 49506

www.babybelovedinc.com

Start your day with Yahoo! - make it your home page

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I think this makes a lot of

sense in a situation where the mother is already using bottles to offer

supplements to her baby as a way to transition back to exclusive

breastfeeding, but I don't think I would ever suggest it to a mother who

has not yet used a bottle. There are too many potential pitfalls to using

a bottle, and the lactation aid offers the same benefits as the

" bottlefirst " method, without these pitfalls. I would think

even giving the baby a bit of milk by cup prior to going to the breast

would achieve the same results as this method.

In my practice, I find that mothers are not often comfortable with

lactation aids. Even when they like the idea of them, they often

become frustrated by them and stop using them, resorting quickly to

bottles on their own. I always talk to mothers about lactation aids

and present the clear advantages, but it isn't a realistic solution for

all of them.

Bottles definitely have a bad rap and deservedly so in many cases.

However, we have new kinds of nipples now that are much better than the

old fast-flow, poorly shaped nipples. We also have great new

methods of giving them thanks to Dee Kassings great JHL article and Tina

Smillie's method of " Bottlefirst. " With a combination of a good

nipple and better methods of giving the bottle, I do not find that

bottles necessarily undermine breastfeeding and so am not uncomfortable

suggesting them to mothers, who in most cases are comfortable with them

and find them to be practical.

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