Kathleen,
        What a difficult place for you to be in:  the friend who is the
expert.  It may be that you need to chose one role over the other for the
next couple of weeks and either forget you're an LC and be a supportive
friend or tell her to help her most effectively, you need to act as if
she's your client......
        Is a referral to an OT or PT an option in your area?  (It's not
here; OT/PTs who work at the *big* hospital are interested in getting
babies to suck on bottles and have no interest, knowledge  or expertise
when it comes to the breast, so if I can't help a mom, it's all over for
her and *I really don't like that*!!)
        I really dislike cases where baby doesn't latch!!!  And it sounds
like this little munchkin has been through the oral stimulation wringer.
I use fingerfeeding w/real SNS (not starter) for as many days as it takes
to extinguish the yukky suck, then transition to breast (using SNS at
breast to begin).  Start at finger w/tube #1, then move to breast w/tube
#2 hooked up.  Posted this once to Lactnet and asked the DB for the post
number...we'll see!  YEAH!!!  It's post #19956!!
        Despite reading some negative Lactnet posts about fingerfeeding I
have real success with the technique.  First, of course, *I* must teach
the baby to suck properly at finger; usually manage this before the
feeding is over and then mom, dad, granny or whoever is there can wash up
and try to see what it feels like.  Use a combination of  a variation of
Chele Marmet's suck training, walking back the tongue, charm hold,
counterpressure on the tongue during the feeding--whatever the initial
digital suck exam seems to indicate.  Fingerfeeding then used exclusively
until the problem is no longer detected, then to breast.
        I (with my LLL background) am concerned that I use so many
doggoned SNSs, but can't come up with anything else as easy for parents
and *effective*.  Will be watching posts with great interest.....
        Karen Zeretzke

On Thu, 03 Oct 1996 08:16:05 -0400 Kathleen Bruce <[log in to unmask]>
writes:
>Hi. I am currently working with a mother who has a 2 1/2 week old
>baby. Born
>2 weeks post due.  Meconium, suctioning, etc.  One week in Nicu on IV
>antibiotics, thrush..difficult time latching then as well.  MOther
>pumping,
>but not as much as she should.
>
>Now...mother pumping 8 times a day doubly.  Baby will not latch at
>all...except sporadically on a nipple shield.  Mother has been coming
>to LLL
>meetings since month 2 of pregnancy..and is very knowledgeable. When I
>saw
>this baby, he would swallow with his mouth *open*...milk that was
>being
>dripped on breast via syringe.  Baby being fed now with syringe and
>largest
>finger..and a wide based bottle also...and will latch onto breast
>maybe
>twice daily with a nipple shield.
>
>Has tried rebirthing bath....and baby just will not latch.  He cries,
>and
>bobs on and off.
>
>This is a friend of mine, and I am really attempting to help her, but
>I am
>not sure I know what to do next.  I do not know if it is the difficult
>birth, or the suctioning, or the thrush (this is resolving with
>nystatin).
>Baby was taken off breast entirely a few days ago. ....to give both he
>and
>the mother a rest from the stress of trying to bf...baby screams so
>much
>that mother is really losing it.
>
>Any suggestions would be most appreciated.  Mother is supporting her
>supply
>with the pump, but she is reaching the end of her rope. I keep
>thinking
>there must be something I have forgotten....and I know how very
>important
>this is to her.
>
>Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet,Corgi-L,TLC, Indep.
>Consultant
>http://together.net/~kbruce/kbbhome.html
>LACTNET Archives http://library.ummed.edu/lsv/archives/lactnet.html
>
>
>
>