Date: Wed, 10 Apr 2002 21:30:06 EDT
From: Nikki Lee <[log in to unmask]>
Nikki Lee wrote: "Mom saw another LC who made all the same recommendations
as did I."

What were the recommendations? Not knowing, I'm afraid I'll ask the obvious
like: What about overactive or slow MER? What about undiagnosed thrush and
a baby whose mouth hurts? What about nipple confusion? What about a labial
or lingual frenulum? Does the mother use a spray-on deodorant or body
powder or nipple cream whose taste is offensive to the baby? What was the
birth like? Did the baby have any orally invasive procedures--suctioning,
etc. Could the baby have suffered some kind of trauma that needs time to
heal and/or treatment? Etc. Then there is the less likely (but still
possible) situation: Could there be an undiagnosed congenital disorder
affecting breastfeeding? Feeding problems are often the first symptom of a
congenital disorder. Rare disorders can take years to be correctly
diagnosed. A baby who won't breastfeed can't breastfeed. There must be a
reason.

And, to complicate matters, was the mother's confidence in her ability to
breastfeed sufficiently shaken by the experience with her first baby so
that it is affecting her perceptions and responses now? She may need the
opportunity to talk *a lot* more about her first experience--for which she
is likely also grieving--before she can fully see the current situation as
a new one with perhaps entirely different causes and new possibilities.

In the current absence of answers, preserving the possibility of
breastfeeding, providing EBM, encouraging skin-to-skin, and providing the
mother with emotional support are appropriate. A few resources are:

The article, "Supporting the Human-Milk-Feeding Mother," at
http://www.lalecheleague.org/llleaderweb/LV/LVFebMar01p3.html
Linda Smith's web page on long-term pumping:
http://www.bflrc.com/ljs/breastfeeding/bfnotwk.htm
Pumping Mom's netlist and other information on exclusive pumping: http:/
/www.pumpingmoms.org/index.html
My article, "Congenital Disorders: Implications for Breastfeeding," at
http://www.lalecheleague.org/llleaderweb/LV/LVDec99Jan00p123.html
My Unit, "Congenital Disorders in the Nursling," in the LLLI Lactation
Consultant Series II.

Best wishes to this mother and baby,

Cynthia

Cynthia Good Mojab
Ammawell
Email: [log in to unmask]; Web site: http://home.attbi.com/~ammawell

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