Jessica wrote:
 "All was fine
until last night, baby refused the breast and would not latch.
There was
not neccessarily much crying, baby would fall asleep, only to wake
again
after 5 minutes crying.  Ped checked (it is Sat night) all things
besides
blood and urine tests which will be done tomorow, and said that all
on exam
seemed  normal.  Baby does not seem lethargic, just won't latch.
Last
night the baby slept 6 hours which obviously had this experienced
mother
very concerned.  What I observed does not seem like behavior shut
off, it
almost looks like baby "forgets what to do".   There is some
rooting, but
baby does not follow through with a suck.  I did not observe even
one
sucking pattern.  Digital suck exam all was normal.  Baby does eat
EBM from
a bottle fine."

I still have a couple digests to read, so someone may have had a
similar response.  My first impression is that the clue may be in
the last line I quoted.  Did the baby take a bottle fine before this
happened?  Some may say "There's no such thing as nipple confusion."
, but this sounds like a classic case.  I have found that some
babies only need an artificial nipple in their mouths one time and
they already expect the breast to feel the same!  Did baby do this
long sleep more than once or is it just 1 6 hour period?  One long
stretch like that wouldn't necessarily be a concern by itself.  If
the parents became aggressive at trying to get baby to breast during
this time, she might be reluctant to go to breast now.  Did mom's
milk volume "kick into high gear" shortly before this happened?  If
so, perhaps baby was overwhelmed the first time at breast afterwards
and became a little apprehensive to return to the breast.

Of course, there may be something that will show up in the blood
work.  It is good that baby is being fed in a way that has less risk
of confusion than the bottle and mom is maintaining her supply.  I
would suggest that when starting the finger feeding, don't
immediately put the finger all the way back in baby's mouth.  Let
the baby draw it in over several sucks.  This will closer mimic the
fact that it takes several sucks for the breast tissue to be drawn
well back in baby's mouth.  If baby gets used to immediate
stimulation of the "S spot" (junction of hard and soft palates) she
may continue to expect it immediately at breast.  Can the finger
feeding be done with baby's cheek at mom's breast? (A little awkward
for mom, but maybe mom can hold baby there and dad's finger can be
the feeding tool.)  With any alternate feeding method, we should be
asking ourselves "How can I do this while minimizing the differences
between nursing and this method?"

You might also want to try "rebirthing" where mom and baby are in
the tub (with someone nearby to help and be alert to the fact that
it can be very relaxing to mom-don't want her to fall asleep with
baby in the tub!)  If you check the archives, I think there have
been descriptions recently of how to do it.

Good luck with this challenge.  It's great that the ped referred
them to you rather than the all too common "just give a bottle and
it will take care of itself" advice.

Winnie Mading IBCLC

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