Just a few thoughts to add to what you're already doing :-)
I see two issues here - the lack of stools/slow to regain birth weight
issue, and nipple confusion. I would want to determine WHY her supply was
low: past history of breast surgery, poor management of breastfeeding
(i.e., too busy with other kids to bfeed often enough, limiting length of
feeds, baby mostly sleeping at breast, etc) Did she have supply problems
with baby #4?
As to the nipple confusion, given that he's already 6 weeks old, I wouldn't
take a break from the breastfeeding, but I would do as you suggested and NOT
frustrate the baby with it - get him off when he fusses, comfort him. If he
won't stay on with the lactation aid and she can't use other alternative
feeding methods, then she might try offering *some* supplement from the
bottle when he fusses, tickling baby's lower lip with bottle nipple first,
so as to stay consistent with how she offers the breast (offer well less
than half the feed, I'd say. An ounce, for those of us who think in ounces.
Or mom can just count to ten slowly while she supplements). Then take the
bottle out, place a few drops of supplement on mom's nipple and try again.
Definitely as much skin to skin contact as her situation allows - do the
other little ones take naps? Perhaps she can do skin to skin with baby
while her other children nap.
I'd also remind mom to RELAX when she offers the breast. Talk softly to
baby in comforting tones, and BREATHE. Sounds funny, but I often find mom
so TENSE that she's literally holding her breath. I've come to believe that
some babies pick up on mom's mood and respond accordingly.
Is mom eating enough, drinking enough, sleeping enough?
Definitely a difficult situation. I don't envy you :-) Good luck, and keep
us updated......
Regina Roig Lane, BS IBCLC for Miami-Dade County WIC
> -----Original Message-----
> From: Yael Wyshogrod [SMTP:[log in to unmask]]
> Sent: Sunday, April 09, 2000 12:41 PM
> Subject: difficult situation
>
> I'd like to ask some advice and opinions in this case:
>
> Mother of 6 week old baby, fifth child (all under 7 years old), did not bf
> first three, bf fourth for 18 months and fell in love with bf. Is referred
> to me with baby refusing breast most of the time, and milk supply
> dwindled. First 4 weeks bf exclusively, was told by nurse "no problem"
> even tho baby stooled every 3 or 4 days; did not re gain birth weight
> until 4 weeks. At four weeks began to supplement, shortly after that baby
> began to refuse breast, mother began pumping, bottle feeding with
> supplemental formula. Currently pumping less than half of what baby needs;
> says baby succeeds in latching and "feeding well" about once every couple
> days.
>
> So far, fairly common (yet difficult) situation.
>
>
> When I saw her, we got baby latched on for brief minute, then pulled off
> and fussed. Tried using lactation aid to get baby to stay on, stayed on a
> couple minutes longer but still pulled off and fussed. The only thing that
> got this baby to calm and stay latched on for more than about one minute
> was when the mother stood up holding baby, rocking him fairly vigorously
> while standing up, and this way getting him on the breast. As soon as she
> stopped moving, baby fussed and cried and pulled off breast.
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