Book Review: Resources for Counseling the Parents of Premature Babies
BREASTFEEDING
YOUR PREMATURE BABY
by Gwen Gotsch. Schaumburg, IL USA: LLLI, 1999
Breastfeeding
Special Care Babies
by Sandra Lang. Bailliere Tindall, 1997
Breastfeeding
Your Premature or Special Care Baby: A Practical Guide for Nursing the
Tiny Baby
by Marsha Walker, RN, IBCLC. Lactation Associates, 1998
From: LEAVEN,
Vol. 36 No. 5, October-November 2000, p. 103
Reviewed by Ann Calandro
Waxhaw, North Carolina, USA
LLL Leaders receive calls
about all kinds of helping situations. One of the most poignant calls
received may be from mothers seeking information about breastfeeding
their hospitalized premature babies. Leaders have a wealth of information
to share from the BREASTFEEDING ANSWER BOOK. However, a mother of a
premature baby may be experiencing many different emotions, such as
guilt, anger, fear, or helplessness, so she may need information in
small increments. A written guide filled with helpful suggestions and
up-to-date information, available when she has time to read and absorb
the information, may be exactly what such a mother needs.
LLLI recently published a
guide for mothers of premature babies: BREASTFEEDING YOUR PREMATURE
BABY by Gwen Gotsch. This is an excellent resource, ideally a part of
every Group Library with another copy available for sale.
BREASTFEEDING YOUR PREMATURE
BABY begins with the basics of breastfeeding, describing why human milk
is especially important for the development of early babies. It proceeds
in an orderly way with a discussion of how breastfeeding, milk expression,
and breast pumps work. There are excellent recommendations on how to
safely pump and store human milk, for dealing with sore nipples, and
for coping with a diminishing milk supply.
This thorough sixty-page
handbook doesn't ignore the emotional side of parenting a premature
baby either. It realistically addresses the normal feelings and concerns
parents may experience. For example, there is a whole section about
beginning breastfeeding that contains lovely black and white photos
and tips on early feedings. Kangaroo (skin-to-skin) care is encouraged
and illustrated. Test weighing and supplemental methods of feeding are
also explained. Finally, the last chapter is full of practical advice
for caring for the baby at home, including resources for the mother
to help her find LLL, pump rental companies, and donor milk banks. The
book is referenced as well so mothers may do further research or share
the medical journal articles with a baby's health care providers.
I have already had one really
exciting experience with this book. A nurse came to my office telling
me about her sister who had given birth prematurely in a small rural
hospital. She was seeking help with breastfeeding. I sent a copy of
BREASTFEEDING YOUR PREMATURE BABY and provided information about renting
a hospital grade breast pump. (This hospital did not own a breast pump,
have lactation services, a nearby LLL group, or health care providers
who were familiar with breastfeeding.) Several weeks later, the nurse
returned to tell me that her sister read every word, shared information
with her health care providers, and was now successfully breastfeeding
her little boy. Never underestimate the power of a determined and informed
mother, armed with an excellent reference!
Another useful resource for
parents of breastfeeding premature babies, Lactation Associate's sixteen
page booklet, [i]Breastfeeding Your Premature or Special Care Baby:
A Practical Guide for Nursing the Tiny Baby, [/i]written by Marsha Walker,
RN, IBCLC, was newly updated in 1998. This pamphlet would also be a
useful guide for parents of premature babies. It explains many of the
same topics as the LLLI book, but without as much detail. It includes
several helpful black and white illustrations of latch on, dropper feeding,
supplemental feedings, and gavage feeding. Walker encourages frequent
and thorough pumping to rapidly build the early milk supply. She also
recognizes that mothers go home with unique babies and varying milk
supplies, so she has written feeding plans with different scenarios.
For example, there is a feeding plan for a mother who has plenty of
milk and whose baby is nursing well; another for a mother whose baby
has received mostly bottle feedings in the hospital; and a different
plan for the mother who has a low milk supply but whose baby feeds well.
Walker has included a useful
list of resources at the end of the pamphlet, including information
on LLL. I particularly like the lists of sources for premature baby
clothing. Parents of little folks are always interested in finding some
clothing that actually fits!
A third resource in the LLLI
Bibliography is [i]Breastfeeding Special Care Babies[/i] by Sandra Lang.
This book, published in Great Britain, is a rich source of information
about premature babies and parents but is geared toward health care
providers caring for tiny babies. The introduction states that "this
is a book about breastfeeding in adversity!" Particularly useful are
the discussions of the development of feeding ability along with helping
the mother position the baby at the breast. Also well addressed are
oral stimulation of the baby, teaching hand expression, breast massage,
and cup feeding. There is also a discussion on nursing a baby with cleft
lip/palate. This book is more detailed and has more technical information
than many parents would need, although some parents may wish to learn
more. It is most appropriate for those who assist the parents in the
hospital - the nurse, the lactation consultant, or the physician.
Some of what Lang writes
may be controversial such as that babies who are settling well at the
breast, have 4-6 wet diapers a day, and are gaining weight, are getting
enough milk. She does not mention stooling, which LLL and many professionals
feel is most important. She also disagrees with test weighing after
feeds, a tool many nurseries have found useful for assessing intake.
Frequently, nurses using an electronic gram scale will discover that
baby really has taken in plenty of milk and does not need a supplement
after nursing. Research has shown that intake is impossible to assess
without a gram scale. Even the most experienced nurses cannot tell exactly
how well a baby has fed.
It is wonderful that there
are now thorough and insightful books available for parents, Leaders,
and health care providers to aid in assisting premature babies to achieve
successful breastfeeding. More and more mothers of premature babies
are getting the information and support they need so that more and more
mothers and babies can go home successfully breastfeeding.
Last updated September 17, 2006 by jlm.
Page last edited Sun Oct 14 09:32:17 UTC 2007.
