June,
My thoughts are if the baby has a severe enough problem to require a
'trach' at this early stage (7 days old) and is being fed by nasogastric
tube, then he is not ready to orally feed. Bottom line is it's all about
the airway; breathing comes first.
So I agree that one of the most important things that mother can do is
to protect her milk supply. Then of course she needs huge doses of
emotional support. I would focus on skin to skin contact, if that is
do-able, and regular frequent effective milk removal by whatever means
is easiest for mom. I would be exploring her feelings, family support,
coping skills and means, and financial situation (e.g. can she hire a
pump).
Sometimes babies with trachs can have the trach removed at a later time
when the initial problem is fixed, if it is fixable. As I recall from my
past life as a nicu nurse, with some babies with trachs, some can and do
go on to bottle feed or breastfeed. I would say that certainly might
occur in the future. Positioning of the baby to NOT occlude the trach,
and pacing the baby while watching for stress cues, would be paramount.
I would think that mother very well might have to continue "insurance
pumping" though.
Laurie Wheeler RN MN IBCLC
Mississippi USA
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