Yesterday we met with the speech therapist from the hospital to follow up on how Sophie is doing at home. (Speech, you may ask? Yes, apparently "speech" therapy includes nippling for babies.) The therapist has been very happy with how far Sophie has come since she was born. But she encouraged us to not push her to hard to avoid consequences in the future.
Most parents take for granted that their newborn will be able to eat (whether that means breastfeed or bottle) straight out of the womb. Sure, it might take some time to latch on the breast correctly, but the ability to eat is something they are born with, right? Not for premies. As the nurses at the hospital explained, eating is the most complex thing that a baby has to do. They have to coordinate sucking, swallowing, and breathing all at the same time. One of the common misconceptions is that if the baby can suck on a pacifier, then she is alert enough or able to eat. A pacifier only requires sucking and breathing; the swallowing part complicates things.
When Sophie was first learning to nipple, she would suck, suck, suck, suck, suck...swallow...breathe, breathe, breathe. It was a very slow process. She now has learned to suck, suck, swallow, breathe...suck, suck, swallow, breathe. This is what allows babies to down a bottle without taking a break. But Sophie still has some issues during her feedings, especially when she tires of nippling. This is where we as the feeder come in. If the nipple has milk in it, it will drip some out, even if she's not sucking. To help her not choke on it, we put her in a side-line position: she's on her side with her neck in a neutral position. By being on her side, if there is any extraneous drips from the bottle it collects in her cheek, not the back of her throat. We keep her hands in front of her chest so her throat and chest are open and she is relaxed. We also look for cues that she needs a break; if her head pulls back or she stops sucking we are supposed to tilt the bottle slightly so no milk is in it. Then we need to realize when it is time to stop; if she is not alert and rooting it is easier for her to choke.
The therapist explained that it is very important for us to not push Sophie too hard so that eating is a positive experience for her now. If she has a negative experience now, she might not be willing to eat solid foods as readily. She also explained that at 3-4 months, babies lose the reflex to suck when something is put in their mouths, so that is also a pivotal time to make sure nippling goes smoothly.
It's hard not to push her; I'd like to see her nipple all of her feeds so that we can have more "normalcy" (and avoid the hassle of the pump). However, as the nurses always said, Sophie has to decide when she's ready. I'm ready whenever she is. :-)
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