Why it’s Time to Stop Teaching Parents Paced Bottle Feeding and Teach Responsive Feeding As Recommended by the AAP

Paced bottle feeding is a wildly popular bottle feeding technique that is promoted as the best way to feed babies who are breastfed. When I did a google search for paced bottle feeding, there were a whopping 572,000,000 results! What’s more, definitions of paced bottle feeding techniques varied significantly, often contradicting each other,  and there were many unproven claims to promoting paced feeding. 

As a 31-year NICU nurse and lactation consultant, I’m mystified why paced feeding for healthy term babies has become the norm. Pace feeding is a therapeutic feeding technique primarily used for medically complex and premature babies whose suck, swallow, and breathe (SSB) reflex is not coordinated or matured, which is essential to bottle-feed without aspirating milk into the lungs.  

The American Academy of Pediatrics (AAP) and global infant feeding guidelines advocate and promote responsive feeding, which is uniquely different from paced feeding.  Full-term, healthy babies are born with their SSB coordination fully developed and can responsive bottle feed safely.

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Is Breastfeeding Twelve or More Times a Day Normal? Not Always

A meme posted by an IBCLC states that breastfeeding 12 or MORE times a day is “normal” with no further education on when it can be a sign of newborn hunger, poor feeding, inadequate milk transfer, or failure to thrive. 

Overly simplistic memes like this are irresponsible and confusing and, in some cases, are the reason why parents miss red flags that require medical attention and lactation assessment to be sure the baby is receiving adequate nutrition and fluids when nursing. (Source of meme to the left, Facebook, Lucy Ruddle, IBCLC)

Here at the Fed Is Best Foundation, we receive messages frequently from families who tell us they were repeatedly assured by trusted health professionals that nursing 12 or more times a day is completely normal. 

But is it always normal?

No, it’s not.  Continue reading

Trouble Breastfeeding? It’s Not Your Fault  

by Heidi Bitsoli, Sunshine Behavioral Health 

If there’s one thing pregnant women get in spades, it’s advice. From your relatives to your neighbors to your coworkers to strangers in line at the grocery store, everyone has an opinion on how to best care for the child you’re about to birth.

And one of the most common pieces of advice you’re likely to hear is how important breastfeeding is, for both mother and baby. But what all those opinionated folks won’t tell you is how hard it is for some women.

The truth is, that your mental and physical health is just as important as your baby’s. If you have trouble breastfeeding, or simply decide it’s not for you, you are not alone. You also aren’t a failure as a parent if you have difficulties breastfeeding or decide against it.

How Common Are Breastfeeding Difficulties?

Breastfeeding difficulties are extremely common. One study conducted by Nutrients followed mothers who were breastfeeding when they were discharged from the hospital, within 72 hours of delivery. At the time of discharge, 95% of the mothers were breastfeeding exclusively.

After one week, 81% were still breastfeeding exclusively. The majority of these women continued with complementary breastfeeding. At one month, only 73% were exclusively breastfeeding. 19% still provided breast milk complementary feedings, and 7% had transitioned to exclusively formula feeding. Continue reading

Dear pediatricians, watch your language; infant bonding happens with a present loving parent not the way they are fed

 

Dear Pediatrician, 

I am writing this letter to open my heart to all pediatricians. I’m hoping that sharing my story will encourage them to watch their language when talking to parents about infant feeding.

As a parent, we naturally want to make sure our children thrive. We entrust pediatricians to care for our children with unbiased and evidence-based information. We rely so heavily on your assurance that we are doing right by our children. We need the “you’re doing great” or “maybe try doing this instead” to help guide us through the ups and downs of parenting these little ones that did not come with an instruction manual. 

Recently, I was at a pediatrician appointment with my second baby, who happens to be exclusively breastfed. Breastfeeding was easier for me the second time around, and my mental state is in a much better place. 

My pediatrician began to examine him. He starts to cry as he does with everyone that isn’t mommy, daddy, or big sister. She looks at me and laughs and says, “yup, he is definitely in the stranger-danger phase now. And I bet it’s even stronger because he is breastfed. Breastfeeding just creates this unexplainable bond.”

I stood there dumbfounded and in disbelief. My pediatrician knows my daughter was formula-fed, and she knows how emotional I was when switching her to formula. But even putting that aside, she is supposed to be a trained professional and understands that breastfeeding doesn’t create “an unexplainable bond” —bonding happens with an emotionally healthy, loving parent, not by the way a baby is fed. I don’t feel a stronger bond with my son than I do with my daughter. They are both my babies, and I love them both equally and unconditionally. 

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How To Prepare For Supplementing When Breastfeeding Your Baby In The Hospital

Mothers who experienced delayed onset of milk production or experienced low milk supply with their first baby often contact us for support to try breastfeeding again. They typically have anticipatory anxiety because they have lost trust in their lactation professionals and hospital staff and are unwilling to attempt breastfeeding again without supplementation. They want to know how to supplement their baby until their milk supply becomes sufficient to feed them safely while providing proper breastfeeding stimulation for optimal milk production.

The most common concerns expressed:

  • Fear of the pressure to exclusively breastfeed
  • Fear of failing to breastfeed again
  • Fear of advocating for themselves and their babies while in the hospital
  • Fear of being shamed by hospital staff when wanting to supplement until their milk comes in
  • Fear of being denied formula or not receiving it promptly
  • Triggers from the previous negative breastfeeding experience, such as being touched without consent

Monica writes: “I lost confidence in breastfeeding because I didn’t make enough milk for my first son, who required hospitalization for severe jaundice and a 13% weight loss. I was devastated and furious when the neonatologist told me he was starving. In my birth hospital, my son had been forced to cry from hunger, and I was told my body would make enough milk for him by every lactation consultant and nurse in the hospital. I trusted them. They were wrong! I no longer trusted breastfeeding and decided to pump and bottle feed to ensure he got enough milk. I purposely delivered my second baby at a hospital that didn’t force me to breastfeed exclusively. After starving my son,  I was not taking any chances, and I supplemented my daughter after every breastfeeding session. My breastfeeding experience was the opposite of my son’s, and I remember tearing up several times because she was so peaceful and never cried.  Thankfully I supplemented her because it took five days for my milk to come in. Supplementing saved my breastfeeding journey, and we are still breastfeeding 19 months later.”

 

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