Reading the account of the twin who is refusing to feed
was like reading the chart of two different babies that
I have been working with.  One is a triplet who had
received some EBM in the beginning (mom never got a
good supply and would distribute what she got among the
three) and the other is a singleton whose mom nursed
and bottled in the beginning, but gave up  on the
nursing because wouldn't trust the amounts no matter
how many feeding assessments we did in the office.  Now
both are bottle fed.  Areas of similarity. Initial
feedings and growth were good for about 2 months. Moms
concerned a great deal about amounts and timing of
feedings (the triplet mom does have to try to schedule
feeds for three).  Babies are arching back, refusing to
swallow, suspected of reflux,. (Both have been tested
and both negative).  Both get the majority of their
calories at night when babies don't fight.  Both have
been worked up by developmental specialists.  The
triplet was found to have a disorganized suck and
swallow.  The singleton no problem.  Both now on higher
calorie formula.

My thought is how much of this could have been avoided
if mom's had been willing to feed on the baby's cues
rather than schedule.  The singleton was doing great
until mom stopped nursing.  I have suggested
relactating, but she is not interested.  The triplets
mom tried to pump and nurse, and her supply was never
enough for one baby (all sorts of fertility problems)
but again if only baby Would have been fed when she
indicated hunger, I believe much of this could have
been avoided.  Now, at less than 6 months, we have two
girls with issues with food.   Just as we try to get
moms to trust in their body's ability to nourish, we
have to get moms to trust in their baby's ability to
know when to be nourished.

Gayle Prehn, RN

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