In regard to the article entitled ” Finger Feeding a Preemie ” (Issue No. 29), in which Jude Kurokawa, CNM, shared her experience in assisting her premature grandson to breastfeed through the use of finger-feeding: I would like to clarify a few important points when working with infants, and especially premature babies, who are having difficulty breastfeeding.
First and foremost, one must feed the baby. Breastfeeding is a learned skill for both mother and infant. Some mothers are under the false impression that if a newborn gets hungry enough, he will simply latch on to the breast and nurse effectively. If a newborn hasn’t had the opportunity to imprint effective suckling, this is not the case. An infant unable to latch on to the breast and suckle effectively can become increasingly weak and dehydrated and genteelly starve. Mothers and those working with mothers who breastfeed need to know how to tell if a baby is receiving enough breast milk and where to go for help. Local La Leche League leaders and/or lactation consultants can be valuable resources in these situations. More and more mothers are receiving information on the advantages of breastfeeding. As these women choose to breastfeed, the greater task of educating our culture about breastfeeding management remains.
Finger-feeding can serve as a transitional feeding method when helping a baby to overcome nipple preference and breastfeed. Finger-feeding by using a 5 French feeding tube, a periodontal syringe, or the Supplemental Nutrition System available for Medela, Inc., can facilitate an infant’s transition to the breast. In Jude’s instance, she was in a remote community and she chose the method she had on hand.
As Jude mentioned in her account, numerous unsuccessful attempts to breastfeed had been made while her grandson was hospitalized. The infant seemed to have a “breast aversion,” having been repeatedly brought to the breast and then been unable to receive gratification. In some cases infants can associate the breast with hunger, frustration, and unsuccessful feeding attempts. To allow the infant time to equate spending time at the breast as something stress-free and pleasant, I suggested that the mother hold the infant and offer contact with the breast without asking him to breastfeed. Meanwhile the baby received nourishment by an alternative method that wouldn’t re-enforce nipple confusion. Cup feeding and finger-feeding were tried; finger-feeding was preferred.
Once the baby began showing more interest in the breast, the breast was offered while Jude, a knowledgeable health care provider, closely monitored the infant’s hydration and stooling. After a few patient tries the baby was able to latch on to the breast and breastfeed. The baby’s progress continued to be closely monitored.
For readers contemplating finger-feeding infants, I strongly recommend they work closely with a health care provider and, if further breastfeeding expertise is needed, those knowledgeable in breastfeeding and finger-feeding such as La Leche League Leaders and/or lactation consultants.