>
> Date: Mon, 1 Apr 2002 22:46:25 -0500
> From: "Trish Whitehouse, RN" <[log in to unmask]>
> Subject: Can you teach an older child to breastfeed? (long)
>
> I'm about to seriously come out of the closet.
>
> I have posted several times about a few different topics, and have said
> that I was writing about someone else. I have Rachel and Kathleen's
> blessings to post this, because my circumstances are unique and I am
hoping
> I can get some feedback from all you wonderful experienced people. I am
> working with an IBCLC/MD, and she has been a world of help and support,
but
> still my situation leaves me feeling so frustrated. I think 10,000 heads
> are better than one, so I am posting this to the lactation world.
>
> I have a 20 month old son...he is the one who had the chylothorax after
> heart surgery and I had to make skim milk for him, and I posted about how
> that is done. He was in the PICU for 3 months after that surgery, and was
> on the skim milk for a total of 3 months. He is now on full fat
breastmilk
> and has been for the last 12 months. So all is well from that standpoint.
>
> He is also the baby with the oral aversion about whom I have written
> several posts. As a result of the chylothorax, he was septic with every
> bug in the book, 2 and 3 organisms at a time, was on and off the
respirator
> so often I lost count, was septic with yeast, and basically was critically
> ill for the whole 3 months. Before this surgery, he was a nursing,
bouncy,
> 8lb little baby. When I got him home, last January (2001), he refluxed
> night and day, had lost 2 lbs, had no voice, on continuous O2, and because
> he had spent so long on his back in bed fighting for his life, he was
> pretty much a low muscle tone blob. Sorry to be so blunt, but I only wish
> I were exaggerating. He took nothing by mouth, slight touch on his cheeks
> would result in him screaming and vomiting. He was on a continuous drip
> via NG tube for feeds. He was also very aversive to touch anywhere on his
> body, would tense up and scream when he was held, and preferred to be left
> alone in the car seat so he could rock his head and get himself to sleep.
> It was not a good sign.
>
> Now, fast forward a year to today, and he is almost 20 lbs, cruising along
> furniture, crawling all over the house, voice is better, starting sounds
of
> words, chases his brother and 2 sisters, loves the sling, cosleeps in the
> crook of my arm all night, and is doing far better than anyone ever
> expected. He is not neurologically nor cognitively impaired. He is a bit
> delayed in his fine and gross motor skills, acting more like a one year
old
> than a child of nearly two. He has been getting my expressed milk since he
> left the hospital.
>
> OK, here's where you all come in. He won't nurse. The oral aversion is
> pretty much healed as far as being afraid to have something in his mouth
> and it causing reflux. He can put pretzels in his mouth far further than
I
> ever could without gagging. He has not sucked since he left the hospital,
> only in his sleep or when I ask him to suck, he'll suck with his tongue.
> He takes almost all of his daily breastmilk via cup, the rest by NG tube.
> We are still working on developing his satiation/hunger drives by allowing
> him to take whatever he can by mouth first, and the remaining volume of
the
> bolus is given by tube. This is done every three hours, over a period of
> one half hour in order to stretch his stomach, hopefully leaving him with
a
> sense of hunger and fullness. My question is this...is there any way to
> teach a baby, now a toddler, but acting like a 1 year old due to the
> traumatic past, how to breastfeed? I have tried skin to skin, putting my
> nipple in when he is sleeping, cobathing, offering it to him any time I
> would have instinctively offered it to my other nurslings, creating
> jealousy when my next oldest pretends to nurse, and it's always the same
> response. He'll laugh, pull down my shirt like he is all done, or he'll
> lick my breast/nipple and then turn away. He has been doing this for
> months and months. Sometimes I get so frustrated and sad, I can't do it
> any more. Other times I think I'm over "this" and it doesn't bother me for
> him to be "non nursing", but then he'll give me some kind of indication
> that he hasn't forgotten, and I keep trying. Just tonight, and what
> prompted me to finally go out on a limb and write this, he kept sticking
> his tongue out as he was drifting off to sleep. (He also does this first
> thing upon waking.) It's as if he is putting it against the upper two
> teeth and playing with it up there, over and over. So tonight, after
> watching him whine and fuss for an entire week with some GI bug, and not
> being able to console him at the breast, I guess I was so desperate, I saw
> him doing this licking thing and put my nipple up to his mouth, cheek to
> breast, and in his sleep, he turned right toward it and opened his mouth
as
> if he would latch. But then he opened his eyes, saw me, thought better of
> the whole idea, and went back to sleep with my breast next to his face.
> Once again, I'm am left trying to fight back the tears.
>
> My OT said that for him to "go back" to "sucking" would actually be going
> backwards because he drinks from a cup so well. She doesn't get it. I
> don't know whether or not these are breastfeeding cues, if it is imprinted
> from the 3 months he did nurse before the surgery, or if I'm just trying
to
> do the impossible and torturing myself in the process. He never took a
> bottle, so it's not like I can transition him from anything to the breast.
> He only drinks from a 2 ounce cup.
>
> My LC (and anyone who knows of Tina Smillie's work knows I am already
> working with one of the best) says I have already given him everything
that
> breastfeeding was ever meant to give a baby...he is happy, attached,
secure
> and thriving. I know she is right. She has also said that the harder
> I 'try" to get him to nurse, the more he will sense the agenda and resist.
> I've seen that happen too. The feeding specialist I am working with is
the
> author of Prefeeding Skills, so you can't get much better in that area
> either. I have tried homeopathy, craniosacral therapy, (though not much
> because he didn't want to be touched), and letting observe other babies
and
> children nursing.
>
> One last thing, not really sure if it adds anything except that you can
see
> just how frustrating this has been. He was born at 36 wks. gestation, and
> after having one of his three open heart surgeries at 4 days of age, and
> came home with an ng tube. Over the period of 7 weeks, I slowly weaned
him
> from the tube to the breast. Just when he had it down pat, he had the
next
> surgery and the whole process was interrupted. Now I have to start from
> scratch again, if I can at all.
>
> So my friends, if anyone has anything to offer in the way of suggestions,
I
> am only too eager to hear them. If there's nothing to say, then a "rah
> rah" would suffice. If I get no responses, I fear I will be left without
> hope, so even if relatching after 17 months and no sucking of any kind in-
> between is impossible, maybe a pat on the back for trying would help.
>
> I think you guys are the greatest, I love reading Lactnet, and I learn so
> much from you every day.
>
> Thank you for understanding why this is even important to me. I'm hoping
> we can all learn something from this discussion.
>
> Trish Whitehouse,RN, LLL Leader,
***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html
|
