I'm working with a mom with twins born at approximately 26 weeks. She has
been pumping  her milk for them which they initially took with gavage
feedings and now via bottle.  Mother has been attempting to get them at
breast since 35 weeks but both babies don't seem to have the strength or
coordination to take the much feeding at the breast.  Doctors wanted to
discharge the infants when they would take oral feedings but at 39 weeks and
6 pounds both these infants are having feeding difficulties.
At the bottle both infants develop severe bradicardia and have needed to be
bagged to bring them back.  The docors feel this is just their immature
neurological system that should improve with time. Mom fortunately is a NICU
nurse in the unit her babies are.  Finger feeding with a starter SNS worked
better but the mom has difficulties if the infants get into trouble she feels
it takes too much time to correct the situation with the equiptment attached.
 She really wants to get these babies to the breast .
 The haven't had apnea or bradicardia at the breast but the aren't get enough
nutrition that way either. The SNS just hasn't been successful with these
infants. Today she is going to use a peridontal syringe  to see if we can
help supplement at the breast for one infant and a Haberman for the other.
Even though this hospital is a medical center it has no IBCLCs hired as LCs.
 They have a feeding clinic whose goal is to get infant to feed well from a
bottle.  This mother needs more specialized experience then I have.
I am asking you experts if you have any input into where a good referral
would be for this family.  It would need to be a phone consult as the infants
are still hospitalized.  This family has two other children and the mother is
exhausted and frightened.  Thank you for any suggestions.
Ruth Solomon, RN, IBCLC