comfort sucking and bottle-fed babies

[Awaken]

Hi, I"m not sure which forum this fits under, but because the baby is being fed EBM mostly via bottle, due to serious breastfeeding challenges, I"m putting it here :)

Posting on behalf of a friend- I know a lot about breastfeeding, but not so much about bottle feeding.  Multiple BF challenges going on, and mom is working around the clock, to get the baby to latch and increase milk supply.  The baby works hard at the breast and with a Lact-aid but she isn't latching well or getting large amounts of milk through nursing.  Most of the feedings at this point are with the bottle. 

SO, I'm just curious, because this is my friend's first baby, and she is trying to figure this out- babies need to suck a lot, and they don't always need to be getting lots of food the entire time, as the bottle would allow.  My babies would always comfort nurse, nurse to sleep, just be on the breast to relax even if they weren't hungry or getting a lot of milk.  So how does this work with bottle feeding?  She doesnt want to overfeed by continuing to offer the bottle if the baby has already drank several ounces of EBM or formula, but if she (the baby) is indicating she wants to keep sucking, is the pacifier the only option?  She doesn't want the baby to be addicted to the pacifier, either, and doesn't want to be offering the paci if the baby is going through a growth spurt and really does want more from the bottle.  She does continue to try to latch the baby on to the breast at these times, but she won't take it for comfort since it's harder work, and the more the baby keeps taking the bottle/paci, the more it seems that ever getting her to latch is out of reach. 

How does one sort out whether to keep giving the bottle after the baby has had a lot, and is still unsettled?  or is this one of those things where there really is no "answer", but every mother and baby has to figure it out for themselves, within reasonable guidelines?  (There are no problems with weight gain, diapers, etc- all is normal)

[AnnieA]

My DD is exclusively bottle-fed breastmilk. She had extreme oral aversions after multiple intubations due to cardiac caths and open heart surgery soon after birth and I was never able to get her to latch. When she was around 5 weeks or so, she wanted to do a lot of comfort sucking in the evenings. She wasn't taking the paci that we had so she kept sucking her bottle. And then she would get too full and throw up. I knew she wasn't hungry because she had just taken 3-4 oz but she wanted to suck. So I went to Target and bought one of each kind of paci and started trying them out. I found one that she liked a lot and so in the evenings after she had had a bottle, but still wanted to suck, I would give her the paci for a little while. I learned to read her cues so if she was truly still hungry, she would swat at the paci until she could get it out of her mouth. She would also do this windmill move with her left arm up by her left ear. No clue what that was about but I knew that when she did that, she was hungry and not just wanting to suck. She's not addicted to her paci though and will only take it when I'm transferring her from my arms to the bed and she stirs but doesn't really wake.

[USAmma]

Neither of my kids breastfed although I badly wanted it for the first one and got all kinds of support. Just didn't happen. I did what I call bottlenursing. I positioned baby just as if she were nursing and offered bottles. Never propped them, never let anyone else feed her in the early months because milk comes from mama. Usually you can tell when bottle babies are hungry vs not because if you offer a paci they will spit it out and root around for milk instead and not be happy with the comfort sucking. My oldest was a finger sucker so that worked out great. My youngest ended up being tube fed for 5 years and she really loved her binkies.

So to answer your question, if it's obviously been awhile since the baby has fed, the baby probably needs milk. But if the friend is not sure she can offera paci or her finger or whatever baby sucks on and the baby will clearly tell you if they want that or want to be fed. I am a new pediatric nurse and have been working with lots of babies since it's RSV season, and this seems to be pretty much universal with all healthy normal babies.

Comfort sucking is so important-- it helps with reflux, it provides exercise for the mouth that will later help with talking and eating solids, and it is a great way to self calm.

[Awaken]

Thank you!  It is interesting to read about your experiences.  That makes sense.  and it also makes sense that it's a mom-and-baby getting to know each other thing, and learning cues, with no hard and fast rules.  I think in time she will just "know" when the baby is hungry and still wanting to eat, and when she just wants to suck.  Sometimes it's hard to give such seemingly vague support, but I do trust that in time they will figure it out :)