I visited a mom and her 2 week old baby today at home for milk supply issues. I had visited this dyad in the hospital at 14 hours post birth for latching issues and noted a very hypertonic arching little guy, who rooted madly, but couldn't settle down to nurse. Even arching profoundly in STS. (She had an epidural..) The baby was fighting everything so I instructed mom to hand express or pump if he continued to fight the breast. Due to his rooting and oral aversion I did not check orally in babe. The next day I did a follow up, and talked briefly as mom said he was "doing well" and "things had really turned around" etc. I felt uncomfortable as I could see he was still arching, but felt dismissed. The FP had followed up and had the Peds internal medicine doc check baby out, and he felt they were fine, so home they went. She rented a pump from me 3 days later. I asked her how her baby was and she said he was still really tense and arching. Yet, she was still not interested in working on the problem of his not latching. I have very very little experience with this issue (mom not wanting help). I told her about an infant massage therapist. At the 2 wk check today he was 1 oz below birth weight and because of his continued arching is scheduled for scans tomorrow. Okay here's the problem: Mom is pumping 6-8 times in 24 hrs and doesn't pump from 8pm-8am. Hence, there's the supply issue. She is supplementing 50/50, and I discovered his frenulum to be a bit tight to boot! He is still frantic at breast and cannot extend his tongue. So I got her set up for clipping prior to scans. You are hoping I'll ask my question. OK. When dealing with multiple issues, it's hard to know where to start. Even if the clipping "works" I'm guessing he'll still be a very difficult little guy to work with. Does anyone have ideas? What has worked for you? She has been instructed numerous times by staff about increasing frequency of feeds and/ or pumping, but doesn't follow. Sorry so long, Chris Clark IBCLC,RCP,CD *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html