I have been working with a Mom/Baby couple the last couple months and am out
of ideas.  Any suggestions would be greatly appreciated.

When baby was born he had a noticably short frenulum, but the pedi told the
parents it wouldn't be a problem.  They were seen in the hospital by my
partner (she's very experienced and has very good skills), who thought baby
was able to get a good latch and Mom felt things were going great.  They go
home and baby proceeds to lose tons of weight and didn't gain for a week.
Her nipples started getting really sore too.

I saw them at 2 weeks and told them I thought the frenulum needed clipping.
Mom pumped and bottlefed until that was done.  The pedi was fairly freaking
out about the weight.  Recommneded formula for the weight loss when Mom had
plenty of milk (I guess she never even thought to ask).  We got the baby up
to progressively harder nipples and after the frenotomy started trying him
back at the breast.  mom felt like he was improving but could never get him
completely back to breast.  Sometimes this baby breastfeeds wonderfully and
other times he acts like he doesn't have a clue. I saw them again and he
acted like he didn't have a clue.

We did try a shield and she started having good success with that, but still
offered bottles regularly (not every feeding) because his weight gain has
never been fabulous.  It's "okay" and nothing more.

Mom isn't comfortable challenging him too much because of his weight, and
frankly I'm not either.  But I know he can breastfeed because he does
sometimes.  Any suggestions on how to get him just breastfeeding?

If his weight is okay next week I did suggest not "giving in" if he doesn't
breastfeed for maybe a few feedings.  We did try the SNS and it didn't help.

This Mom is really committed but that initial weight loss scared her.  Any
suggestions are greatly appreciated.

Andrea Tran RN, IBCLC
Boulder/Erie, Colorado
Where the fires are better but it's hot today!

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