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Thread: Bottle bias?

  1. #1

    Question Bottle bias?

    Separate from the issue of whether breastmilk is superior to formula, there seems to be a bottle bias at many hospitals.

    Doctors, nurses and parents of preemies often say things like:
    -breastfeeding takes more effort than bottle feeding
    -breastfeeding burns more calories than bottle feeding
    -breastfeeding is more difficult for a lot of babies
    -bottle feeding gets most babies home sooner

    Is there any research to back this up? Is there really a medical reason to go from an NG tube to a bottle first if the goal is exclusive breastfeeding?

    On the flip side, are there resources to support a "tube to boob" approach for babies born prior to about 34 weeks, or exclusive breastfeeding for 34-36 weeks preemies?

    We're anticipating the early arrival of our third son, who will most likely be born between 30-36 weeks due to ongoing preterm labor and possible iugr.

  2. #2
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    Default Re: Bottle bias?

    Hi mama, and welcome.

    Having a preemie is hard. And confusing. I wish that I would have been more ready (of course you're never ready).

    In our situation, our LO was on the NG tube and bottle fed at first because he couldn't figure out the breastfeeding. From what I was told at the time, obviously he needed nourishment and needed to gain weight. Having no idea what I was doing I listened to them. He was bottle fed strictly EBM, and I went to the hospital every three hours (which was his feeding schedule there) to attempt to BF before he fed from the bottle.

    Would I do it differently knowing what I know now? Maybe. I know that you can request spoon, syringe, or NG feedings exclusively until they can BF...but for our son, he just couldn't get it till almost his due date. Our LC said that this is common. He was discharged from the hospital at only 3.13 so he was still very small, still 5 weeks till his due date, and just wasn't ready to buckle down and understand the whole boob deal. Once he figured it out, we had no problems. He was a great BF'er.

    Let me see if I can find some of the research I have done since and link them for you. Might be a day or so.

    Good luck with everything. No matter what happens you are prepared to BF and that is such a wonderful thing. It is hard to see the moms that gave up so easily.

    I'm Hillary
    Wife to Gualberto
    Mom to Nolan
    Born at 32 weeks-3lbs/10oz
    11-25-2007
    Our precious early angel


    Remember, you are not managing an inconvenience; You are raising a human being ~ Kittie Frantz
    Unthinking respect for authority is the greatest enemy of truth ~ Albert Einstein
    First they ignore you, then they ridicule you, then they fight you, then you win ~ Mahatma Gandhi
    Looking for more information about vaccines?

  3. #3
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    Default Re: Bottle bias?

    i heard the same things with my son.. he was IUGR, and i had preterm labor so was put on brethine... anyway he was born at 36+6... at 3.10 lbs.

    they never even suggested a SNS or spoon feeding to me.. i put him at the breast at every feeding, and he was just too little to get it, so i had to give him formula for a few days, then i got my milk in and gave him EBM in a bottle.

    i exclusively pumped for my LO till he was 4 weeks old. then he was big enough and figured it out, hes 15 weeks old now and we havent had any problems..

    im sure i didnt answer your questions lol.. but IME, all of the statements were true for my LO. he was too weak. and very sleepy.
    Student aspiring to be a Chiropractor and mother to Noah who will be 3 in July and Olivia who will be 2 in Aug.

  4. #4

    Default Re: Bottle bias?

    Please do pass on whatever else you can find! Thank you.

    I found some research that suggests that breastfeeding is actually less stressful for the baby. Likewise, babies can begin "pre-breastfeeding behaviors" often well before they are able to coordinate the suck, swallow, breathe thing well enough to feed from a bottle. These behaviors - suckling, nuzzling, skin to skin contact, etc. - are good for the baby and the mom and seem to improve outcomes.

    For a mom who is stressed about having a preemie - and stressed about breastfeeding - it makes sense that breastfeeding could be more stressful for baby.

    When I was in the NICU with our second, the mom who was sharing our room tried breastfeeding for about 5 minutes before she decided it was too hard and gave up. She was so anxious about her son's condition (heart issue, I think?) that it was too much to face. As a second time mom who had bf our first for almost 2 years, breastfeeding felt like the most natural, nurturing thing I could do and I was totally relaxed when the doctors finally said it was okay to try. Our son took right to it in part because I knew what I was doing.

    Around the same time my second son was born at 35 weeks, I had a good friend give birth to preemie twins at 34 1/2 weeks. She was told from the beginning that they probably couldn't breastfeed and that she probably couldn't produce enough milk. There weren't any medical reasons for this, it was just the attitude of the hospital. Sure enough, this is what happened. They spent the girl's whole first year worried about formula schedules and oral aversions and growth charts. We just breastfed on demand and relaxed...all three kids are now 18 months old and basically the same size. But we had very different years.

    I guess I have a few specific questions:
    1. When would you try to initiate breastfeeding? When would you wait?
    2. What alternatives are there to ng tubes or bottles for a baby who is on the edge of being able to breastfeed?
    3. For a baby who is say 32-24 weeks, is a ng tube really preferable to a bottle in terms of breastfeeding?

  5. #5

    Default Re: Bottle bias?

    Honestly (and this may be a controversial view, especially on a breastfeeding website!) I was told the same things when my son was born at 32 weeks and it makes complete sense to me that the doctors are right. Although breastfeeding is completely natural, a baby surviving after being born prematurely is not necessarily natural (meaning, without the intervention of doctors and machines. DS would have died on his first day of life if it weren't for them). So it makes sense to me that some babies may not be able to breastfeed so early.

    DS was 4lbs 6oz when he was born, I pumped for him while he was in the NICU and it was given to him via tube to begin with and then later via bottle. I didn't even attempt to push the breastfeeding until he left the hospital to be honest, although the doctors were aware that I did intend to BF.

    While he was in the NICU we did kangaroo care every day and he did latch and suckle a little. I think that helped him feel less stressed, I think it was very important to have done that.

    We finally got him totally breastfeeding at 4 months old (tongue tie was an issue too, which is why I think it took so long) we eased into it, gradually replacing bottle feeds with breastfeeds. He's a year old now, still breastfeeding like a champ and weighs 21lbs.

  6. #6
    Join Date
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    Default Re: Bottle bias?

    Have you checked with your local LLL group. LLL has a pamphlet about breastfeeding a premature baby, and the lending library may have some books on the subject. Just thinking it may be easier to plead your case with something in print.

    Best wishes for you and your LO!
    2001 2004 2008

  7. #7
    Join Date
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    Default Re: Bottle bias?

    I was once supported by this community when trying to start breastfeeding my 25 weeker (almost a year ago). Thanks to the data shared by one of the leaders (Karen Gromada), I was able to make my daughter's feeding plan more breastfeeding -riendly. Now my daughter is 14 months old (10 1/2 mo. adjusted) and has been a very healthy, well-developing, and happy baby. She nurses like a champ!

    The reseaches support that breastfeeding is physiologically less stressful to the preemie babies. There is a Journal of American Academy of Pediatric article (1997) done for these extremely low birth weight babies (less than 800g). http://pediatrics.aappublications.or.../full/100/6/e3
    According to this article, those micropreemies exhibited better O2 saturation level & respiratory rate, and maintained temperature better while breastfeeding compared to when they were bottle-feeding. They did not find much difference in heart rate. This study is a ground breaking study for the littlest babies like my daughter. There are more preceeding studies done for bigger babies who are born at later gestational time.

    It is possible for preemies to transition directly from gavage (tube) feeding to breastfeeding, according to a California project (a collaboration between many professional groups including California Association of Neonatologists, David and Lucile Packard Foundation, and the State of California Department of HEalth Services, Maternnal and Child Health Branch). This project also claims that bottle-feeding is not a pre-requisit for breastfeeding (babies do not prove they can bottle-feed BEFORE practicing breastfeeding.)

    I have read that supplemental nursing system or finger (NOT syringe) feeding can be used to supplement breastfeeding. Also bottle-feeding, if breastfeeding friendly nipple was used and working with qualified and experienced LC, can be compatible with breastfeeding.

    In my case, I was able to breastfeed my baby almost at the same time she practices bottle-feeding. I observed that my babies O2 levels and respetory rate were always stable (and more stable than when bottle-fed) while breastfeeding. It took some time for her to be able to breastfeed exclusively, because her mouth was small, and it required more calories for her to complete her breastfeeding than bottle-feeding at the time. Nevertheless, I was able to breastfeed while she practiced bottle-feeding.

    Good luck! Hope you will enjoy breastfeeding your baby.
    - - - Penga (@ 32 weeks gestational) and my DH

    Mother of two girls:
    Sydney (born 10/31/01- nursed until 3 yrs & 10 mos)
    Penga (born 08/15/07 - former 25 weeker who loves to nurse)

    & no more!

  8. #8
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    Default Re: Bottle bias?

    Quote Originally Posted by @llli*wakawaka View Post
    I was once supported by this community when trying to start breastfeeding my 25 weeker (almost a year ago).

    Good luck! Hope you will enjoy breastfeeding your baby.
    Wow mama! You are an inspiration!
    I'm Hillary
    Wife to Gualberto
    Mom to Nolan
    Born at 32 weeks-3lbs/10oz
    11-25-2007
    Our precious early angel


    Remember, you are not managing an inconvenience; You are raising a human being ~ Kittie Frantz
    Unthinking respect for authority is the greatest enemy of truth ~ Albert Einstein
    First they ignore you, then they ridicule you, then they fight you, then you win ~ Mahatma Gandhi
    Looking for more information about vaccines?

  9. #9

    Default Re: Bottle bias?

    Our son is here!

    Zephan was born one week ago at 31 weeks 3 days. He was 3 pounds 13 ounces. Overall, he's doing really well.

    It looks like our NICU is very supportive of breastfeeding. There are lactation consultants here almost all the time, they are fine with a "tube to boob" approach, they've already had Zephan and I working on breastfeeding. He's very interested in eating and he's been able to latch on a little, which is sweet. We won't start counting the calories he gets by breastfeeding until he's closer to 34 weeks, but the hospital is totally supportive of going "ad lib" at that point and letting us breastfeed on demand as long as he's healthy and growing.

    Right now, we're having a little challenge as they've been adding HMF to my expressed breastmilk, but he's not tolerating it well.

  10. #10
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    Default Re: Bottle bias?

    congrats!!!!!!!!!

    sounds like he is doing great! what is HMF? fortifier? my LO didnt do well with that stuff either.
    Student aspiring to be a Chiropractor and mother to Noah who will be 3 in July and Olivia who will be 2 in Aug.

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