Dear Rhonda and all:
I don't think the gestational age for the development of sucking has changed
other than we are more aware of the age range at which it may occur. Some
perfectly normal preemies will not suck well until 35-36 weeks to term, yet
others will suck well from 32-33 weeks. I think preemie care is fascinating,
however I don't have much personal experience with it. My most recent
experience was with a mum who had preterm twins at 31 weeks. They did well
only ever receiving EBM, first from a gavage tube, then from bottles, and
then the breast. We did have many discussions regarding offering the bottles
and nipple confusion was a big issue. The mum was pumping amazing amounts of
milk. However, the hospital would not let them home (unless they went AMA)
until either the mum learnt to gavage feed/babies were either successfully
breast/bottle feeding EBM. They decided to go with offering bottles and trust
there would not be nipple confusion (they read every drop of research and the
latest seems to indicate that nipple confusion is a myth??). Once they
started feeding from the bottles, they realised just how long it took their
little ones to feed and how quickly the babies got tired. However they all
perservered, babies came home around 35-36 weeks taking both breast and
bottle, and are still totally breastfed until this day (16 months later).
They did try to institute kangaroo care, but the nursery staff were
unfamiliar with the evidence, however both parents held their babies skin to
skin for feedings and whenever they could. Of course when they took them home
they could do this more often. I think we all have to remember that those who
work in the SCN see a lot of cases of failure to thrive and very sick babies.
That's all, marilyn
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