The science and physiology of breastfeeding has always been a great interest of mine. Partnering with IBCLCs early on taught me so much. They instilled in me a desire to learn and understand the critical implications for our bottle-feeding practice with infants, especially with my work supporting preterm infants and their mothers in the NICU. The works of Paula Meier (regarding the infant-controlled flow rate at the breast — -once mother pumps through letdown—and how it reminds us then to offer a slow  controlled flow from a man-made rubber nipple, to minimize adaptation required and optimize safety). The works of Nyqvist about successful breastfeeding experiences as early as 29 weeks PMA (I suspect likely related to controlled flow rate that absolutely best supports breathing stability for suck-swallow-breathe synchrony). With every mother in our NICU that I am blessed to work with via consult regarding bottle-feeding, if mother is pumping, I advocate for early nuzzling, early breastfeeding, and share the research (in a simple way) about flow rate, how breastfeeding is actually easier than bottle feeding for preterm infants, and that breastfeeding always facilitates progression of bottle feeding skills  (in my experience). The infant-guided nature of breastfeeding that supports the “dance” between mother and infant is at the heart of trust, communication and trauma-informed neuroprotective care.

Too often I hear well-intentioned caregivers in the NICU tell mothers that breastfeeding is harder for preemies, and I see the sadness come over the mother. I am always so grateful to be there to gently reinforce what the evidence tells us and encourage our mothers on behalf of our infants.

I can’t imagine working with bottle-feeding infants without understanding the science and physiology of breastfeeding. In every course I teach we carve out time to discuss the science and physiology of breastfeeding and how we can best support bottle-feeding experiences that facilitate continued successful breastfeeding.