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On the subject of Finger-Feeding of a
Premature Baby we are happy to present two fine articles, the first one written by a
person who has recently went through the experience, and the second written by the
Lactation consultant who helped her through the experience. The two articles are:
Finger-feeding a preemie.
written by Jude Kurokawa, CNM
Master Zacheriah Hawkeye Wilson came home from
his six-week hospital stay weighing a lusty 3 pounds, 15 ounces, up from a birth weight of
2 pounds, 13 ounces. He was born 10 weeks early by cesarean, necessitated by my daughter's
severe pregnancy-induced hypertension. He was very small but healthy, in spite of his rude
entry into the world.
When he came home, he was mostly bottlefed pumped breastmilk, with two attempts at
breastfeeding per day. The NICU nurses repeatedly reassured my daughter Kari that
"Preemies don't get nipple confusion." To that I say a re-sounding
"Baloney"! Within a few hours at home, I recognized typical nipple confusion
behavior. He would either take three sucks and fall asleep, or would "bob"
frantically at the breast while screaming, then fall asleep.
We followed the nursery schedule for the first few days, offering Zach the breast, then
cup feeding him the rest--an extremely frustrating experience. Finally, after four days of
this, we decided to "cold turkey" him. The lactation consultant suggested he
might have a "skin aversion" since he was hurt nearly every time he was touched
in his first few weeks. She recommended "wearing him" skin to skin nonstop if
Kari was willing, and of course, she was. We stopped all bottles, pacifiers and cupping,
and offered the breast at least every two hours. If he had a dry diaper after two to three
hours, we "finger fed" him. This was a new trick to me, but it worked like a
charm.
For the uninitiated, finger feeding is taping a number 5 French infant feeding tube to
the side of the middle finger and inserting the finger into the infant's mouth, pad side
up. Attach the feeding tube to a 30 cc syringe with the plunger removed. Fill the syringe
with breastmilk and let him suck; he is rewarded with every suck. We only had to do this
for a few feeds before he got the idea that the same thing works on the breast. I came
home from work the next day and there was Kari, staring at Zach at the breast. She looked
at me and said, "He's doing it!" We held our breath for two days, afraid it
might be just a fluke, but he never slowed down after that. We weighed him every other
day, and the first two days his weight stayed the same. Then he began gaining between
one-half ounce to an ounce each day. At three months old, he weighed a gigantic 7 pounds,
1 ounce.
I hope the finger feeding technique is as helpful to others as it was to us. I can't
give enough thanks to LaLeche League lactation consultant Linda Healow, RN, in Billings,
Montana. She was so reassuring and positive. Even though I'm a retired leader myself, it
just isn't enough when it is your own "world's greatest grandson."
Originally published in the Spring 1994 (No. 29) issue of Midwifery Today
Copyright 1994, Midwifery Today, Inc.
About the Author -
Jude Kurokawa works full-time at a rural health clinic and does family
practice volunteer work at the Indian Health Service in Wolf Point, Montana.
Finger-feeding a preemie Follow-up Letter.
by Linda Killion Healow, RN
In regards 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, that 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, dehydrate and genteelly starve. Mothers and those working with mothers who
breastfeed need to know how to tell if a baby is receiving enough breastmilk 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.
Published in the Spring 1995 (No. 33) issue of
Copyright 1995, Midwifery Today, Inc
The Author -
Linda Killion Healow, RN
Billings, MT
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