Hi all, 
        I would love to bounce a visit I had yesterday off of 2000 experts.
 It is so nice to be able to ask advice and support from all you wise women
and men out there.
        I saw a 5 day old baby with Down Syndrome yesterday.  The baby
latched on a few times but when they called me she hadn't latched for a
day, they were cup feeding her.  She was a little jaundiced when I got
there but they had her in indirect sun and were keeping an eye on her
color.  When I got there the mom was in bed trying to latch on with no
luck.  First thing I did was get her into a better position and try to help
get the baby on.  Wasn't working, I could see the baby wasn't opening and
seemed to be pulling in lower lip and I couldn't see her tongue.  I
suggested finger feeding and the mom wanted to do it.  when she had her
finger in there she said the baby's tongue was way back and not down at all
and she was clamping down.  we were able to get her to occasionally bring
her tongue down for one or two sucks before she clamped down again.  I
tryed to message her jaw to get her to relax, that helped but we still only
got a few good sucks.  She took over 1/2 oz and the mom was happy .  The
baby was content to have grandma give her a rubdown in the sun as she
looked around, much more alert after being fed. (she has the cutest round
little face)
        OK,  I left her with written notes on fingerfeeding and that this
baby needs to eat frequently and we will continue the fingerfeeding and
pumping and keep trying to latch on if she felt the baby's tongue go down. 
I stressed, feed the baby, and how great her milk was and we are taking one
step at a time, first lets get her tongue and suck going and then we will
work on latch.  She has a mini electric and is getting a double pump today.
 her milk supply is fine now she was rock hard and we pumped over 4 oz per
breast to get her soffened up.  someone told her only to pump out an oz or
she would have oversupply.  
        I spent about 3 hours there with her and I left her wishing I could
have gotten the baby latched on.  The mom was happy to have a plan and
seemed less overwhlemed.  I know not every baby goes directlly to the
breast but it would be nice : )   Any advice from the wise ones out there??
 This is the thrid Down Syndrome baby I've worked with and the first that
didn't latch on after better positioning,  the others had better tongue
positioning.  
        Sorry it's so long,  I want to make sure I'm doing my very best for
this dyad and I know there are LC's and moms out there who have much more
experience with Down syndrome than I do.

TIA,  
Rene R Fisher  BA, LLL, IBCLC
Middletown, NY

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