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‘Prop’ feeding’: looking at the evidence
As a twin mother, I struggled to feed both my babies at the same time and I wondered how others managed. I did some research in my local community and found that 76% of twin mums surveyed (a 2016 survey of 60 twin mothers who currently or recently fed twins – at least one with a bottle) had ‘prop’ fed, which is when you give a baby a bottle by leaning it against muslins or other support rather than holding it for the baby. Many professional organisations and literature (e.g. here, here, here, here, here) state that you shouldn’t prop feed because it is dangerous. I wanted to find out what the evidence for this was.
After contacting several UK leading healthcare professionals, NHS feeding specialists, dentists, infant nutritionists, midwives, nurses, health visitors, twin nannies and multiple organisations, no one has been able to recall any incidents of injury or death solely attributed to prop feeding, nor locate any recent or relevant research or evidence-based information on the subject of prop feeding. And I have not been able to find any incidents reported where prop feeding specifically has caused injury or death. One article warning against prop feeding, published by Sandwell and West Birmingham Hospitals NHS trust, warned of risk of choking, ear infection and tooth decay. But the risks were connected to bottle feeding a baby who is lying down, allowing a baby to fall asleep while feeding or a baby being left unattended, rather than feeding with a prop specifically. The article cited a lifestyle blog which doesn’t give any medical or factual evidence itself. I contacted Sandwell and West Birmingham Hospitals NHS Trust about this and they were not able to verify their sources or explain why they used a non-medical source. As a result they decided to remove the leaflet completely from their website.
The NHS Choices advice page states that you should “never leave a baby alone to feed with a propped-up bottle”. This highlights that prop feeding and leaving a baby unattended are two different things and seem to have become intertwined in advice to parents. It’s common sense that you shouldn’t be leaving your baby unattended when feeding in any case. Ultimately, in a bid to find a solution to feeding twins at the same time, I ended up designing a soft pillow to hold a baby's bottle for hands-free feeding which is in line with advice for bottle feeding. The FeedingBuddy allows the baby to move away from the bottle when they want and can be used in an upright/semi upright position. It enables twin mums to feed both babies at the same time (at least one with a bottle) and have close physical contact with one baby at each feed. In other words, it allows prop feeding whilst following the mainstream safety advice for bottle feeding.
I hope there’s a reconsideration of this issue and more evidence-based advice is made available. Mothers of multiple children shouldn’t be made to feel guilty for trying to feed their babies. And of course I’ll continue to look out for new evidence, and get feedback on the FeedingBuddy from professional healthcare organisations and individuals.