don’t confuse moms over nipple confusion

When my 17 year old daughter was born, I was cared for by usual post natal routines of the local hospital of my home town. To help me sleep through the night after my birthing ordeal, hospital nursing staff suggested that they keep my baby at the nursing station. Since I was not yet producing breast milk, only colostrum, they alternated breastfeeding sessions with bottle fed formula. Bottles of sterile water and formula were provided to me in my room to use if I felt the need, and the Welcome Wagon package included a soother.

My next daughter, 14 months later, was not given such liberty. Although sterile water was still available, I needed to request for formula if I wanted it. Soothers, also, would be supplied, if I wanted one.

Three years later, as I carried my third child, clinical professionals across the nation were urging healthcare workers to pay attention to a problem termed, “Nipple Confusion.” According to research, some newborn babies have difficulty latching on to their mother’s breast after using synthetic nipples and soothers. In order to avoid this, a flat line policy was being applied in post natal wards everywhere which denied breastfeeding newborns any access to synthetic nipples.

Now duly qualified as veteran mom with my third baby in my womb, I purchased my favorite soother at a drug store, and packed it into my overnight bag. When my newborn daughter refused to be consoled the morning after her birth, I unpacked and washed the soother. It was no sooner in her mouth than a nurse arrived in my room and urged me to remove it. Usually I smile and submit under external pressure such as this. This time, however, I mustered up the strength to reply, “I’m the Momma. She’s gonna have a soother, thanks.” She graciously complied, and no one bothered me again (I think the words, “Don’t mess with the Momma,” were noted in my chart.)

Moving forward again to the birth of my fourth child, who was born with two unrelated birth defects, including the absence of an esophagus. My son was physically incapable of moving food from his mouth to his stomach. The resulting secondary issues were enormous and we have dealt with them for a decade, but at that time, I remained constant in one thing.

In the event that the doctors were able to perform surgery and connect his tissue between throat and stomach, I wanted this child to have the ability to suck, to grasp a soother and to be able to move his muscles in the instinctive positioning that all babies learn. I requested that a soother be given to him at all possible times, to comfort him, and to allow him to both learn the sucking reflux, while simultaneously motivating him to stimulate saliva, another important need.

You would think that the nurses would follow my wishes, now that I was a mother four times over, step mom to three other young children, and a woman who had clear medical reasoning behind her request. Despite this, I still had to argue with some nurses, who refused to give him a soother, citing nipple confusion issues and textbook analysis of my unwise wishes. I fought with them, now that I had the strength to know that although I was not following best practice, I was doing what was best for my son. Whether or not they followed my wishes for the many hours that I left him alone in their care (he was in the hospital nine months before he came home to our family) I don’t know. But I know that if it weren’t for my previous experience of three babies and the observance of changes in hospital policy, I wouldn’t have had the gumption to insist upon my wishes.

I had a conversation recently with an RN in training. She mentioned to me that she had just finished her term in pre and post natal studies. I considered that this might be a good topic to chat about for awhile, and mentioned that my younger sister had just brought home her second newborn baby girl the week previous. While in the hospital, she was flatly denied her request for a bottle of sterile water, despite the three hours of incessant crying her baby had endured.

I mused that caregiver practices in the postnatal ward had changed over the years. “It’s interesting, “I stated, “How nurses can be undoubtedly certain that any particular post-natal ward procedure is the absolute “Best Practice”; however within a few years, will adapt to firmly promote completely different messages.”

This dear student, bless her heart, then proceeded without delay to explicate the dangers of introducing bottles to babies, and the resulting risk. I thought back to my own four babies, sixteen nieces and nephews, and friends’ children that I held and cared for over the years. I nodded and smiled, and moved on to another topic.

I am not so ill informed as to think that Nipple Confusion is not a problem for some babies. I am well read and experienced enough to understand, however, that the ability for a mother to comfort her child successfully, be it synthetic as it may, sometimes does a world of good for both of them. A balance between the conscientious care of the baby and the self-confidence to “Be the Momma!” will improve the quality of life for mother and child. Perhaps further studies will again develop a different approach to bottles in the future.

We operate in a rapidly changing world. What is accepted as the appropriate response to medicine will continue to change in the months and years ahead. Consider the changes in medical practice guidelines relating to diabetes, mental health, and AIDS in the last decade. We must assume, then that the forthcoming ten years will bring further advances and adjustments to clinical procedure.

With that in mind, is it ultimately important that Best Practice is deemed Perfect Practice? Within a few years, some luckily funded researcher will improve our treatments again, and policies will need amendments.

In the meantime, let Momma’s be Momma’s. Give them the full satisfaction of caring for their children. Not everything is written in stone. In fact, in mothering, most approaches should be as soft and gracious as Mom.

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