I could use some feedback today on a case.  Client came to me yesterday.
Baby born two days previous. 8 lb baby approx. Slightly less. Palate normal,
suck good. Baby fed only three times yesterday, and not really well. Mom's
nipples are broad, and flat, like buttons on an upholstered couch. Moderate
engorgement.  Baby just could not get a mouthful, and bobbed up and down
continuously, crying and frustrated.

Mom came to me...we tried a nipple shield, which worked ok. Baby sucked,
swallowed some milk, and fell asleep. I suspect she did not consume enough
calories at breast  even with shield.  I tried shield because it was LATE 10
pm my time, and mother was at her wits end, and had tried all the other
interventions throughout the day with only slight success. No bms at all in
the past few days.

Mom then pumped out approx 2 oz mixed colostrum/milk, and Dad fed via
periodontal syringe approx 2/3 oz. Baby then fell asleep.

Mom reports this am that baby can't latch without shield....and she is
worried.  I am not sure which is worse. Using the shield, and then trying to
get rid of it, or not using it and having a baby that can't latch..

Any help will be most appreciated.

Kathleen
Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet,TLC, Indep. Consultant
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