Last issue Jan Barger asked about what to do with babies who don't
latch. I know you have a lot more experience then I do, Jan, so I know
you're not asking the question on the level I'm going to answer it, but
I'll throw in my $0.02 anyway. Mostly because I want to know what other
folks' experience is in this area:

I've found in my experience that lots of skin to skin, pumping and
alternative feeding (which for some moms means the bottle), eventually
works if mom can hang in there. Support is key, and recently I've
started using moms who've been through it to support those who are
dealing with no latch.

I really push keeping baby with mom (as much as mom's lifestyle and
personal philosophy will permit), slings, skin-to-skin, and giving baby
lots of opportunites to do a little step by step crawling down the
breast. It's important to encourage moms that when the baby crawls down
the breast and then falls asleep before even mouthing the nipple, or
after sucking twice, that these are positive baby steps, not failures.

We want to give her the long view--it doesn't have to happen today, and
to expect "two steps forward and one step backward" etc. We let baby be
in charge, but put baby with mom a lot, first wehn baby is sleepy, right
after an alternative feed, so baby has opportunity to sleep and wake up
happily skin to skin at chest, and is there for earliest hunger cues.
Mom needs to learn whether her baby likes to be helped to the breast, or
whether s/he'd rather do it him/herself. I find many babies are more
willing to let mom help with latch if baby initiates the session by
starting that crawl down from neutral territory up between the breasts.
And others don't need mom at all if they'll just "let me do it myself".
I love watching that little head bob and the baby grunting (if the baby
doesn't seem frustrated I interpret this grunting to mom as "I'm working
here, I am going to figure this out").

I do stress that we don't keep baby at breast for one second after
frustration--either mom's or baby's-- sets in; let baby suck on finger,
or put baby back up between the breasts high on her chest, or hand baby
to dad, to calm infant, and if hunger is getting in baby's way, we go
quickly to whatever alternative feeding they're using. sometimes if mom
or baby has totally had it, we give a whole feed, but if mom thinks baby
is up for it, and she is too, she'll only offer enough to calm the baby
and go back to working on it.

I had two different moms a while back, (one baby is now 7 mos old and
the other 14 mos old) whose babies didn't latch until they were about 5
or 6 weeks old, and then only sometimes, and both of these infants were
not finally fully breastfeeding at the breast for all feeds until age
three months. One of these moms was incredibly relaxed about the whole
thing-- her mother in law had said, about day 2 or so, "don't worry
about it, your husband didn't latch on til he was a month old." But both
of these moms were just as stubborn as their babies. After these babes
were nursing fine, these moms kept pestering me about what they could do
to help other moms, so they then provided the backbone for a little
support group we started this summer when I happened to have several
moms at once whose babies were'nt latching, and then those summer moms
are now the "graduates" supporting a new group of no-latchers. We meet
twice a week in one of the mom's homes. It really seems to help them
hang in there.

So far, in my experience, and I would love to know what other folks'
experience is here, it seems that if babies don't latch in the first
couple weeks or so, then they don't seem to latch on until they are
somewhere between four and six weeks old. It seems as if they either do
it in those first couple weeks as a newborn thing, with those little
newborn behaviors, or else they have to reach a certain developmental
stage to then learn how on their own terms. Now I don't know if this is
a real observation, or just my accidental anecdotal experience.

Has anyone had a baby (other than a premie, whose neurodevelopmental age
I don't know) who latched on at three weeks?

Also, and I'm sure my experience is very limited here, so far I haven't
had a mom who was willing to hang in there whose baby didn't eventually
latch. But it's a lot for a mom to do, all that pumping and alternative
feeding and skintoskin and weeks of no latch despite all the work, and
we want to be careful that the support is real support for her, and not
unrealistic pressure, that doesn't make the mom feel like she has to
live up to other's expectations. But of course the other moms are
wonderful about this, and we talk about all the other things that go on
in any of our lives that get in the way, and they have been very
supportive of the couple of moms who were just too overwhelmed, and
indeed those women were in a lot more difficult circumstances and
everyone had a lot of respect for them... Anyway, so far, in my limited
experience, if the mom's circumstances allowed her to hang in there, the
babies eventually latched on. This is not to count the unusual
situations, like premies, or the mom of the four month old who wanted to
relactate after weaning at two months.  (altho this current group
includes several 34-36 week type premies: one started latching before
she could get to the first meeting, one is doing nothing, at seven weeks
old and three weeks post due date, and one is only one week old and a
few days postdischarge, to soon to comment. We also have a teen mom with
a fullterm infant who's pumping great and hanging in there...)

Anyway, I'm hungry to know what others' experience is here, and what
else we might do to help these moms.

Tina Smillie