In a message dated 9/29/2003 3:24:38 PM Eastern Daylight Time, [log in to unmask] writes:

> mom has been holding him close to her
> breast without trying
>             to latch him because it seemed he was developing an aversion.
> No latch achieved.

Does "holding him close" mean kangaroo mother care skin-to-skin? I'd suggest implementing several times a day if she hasn't already been doing this. 


>             >>Tried cradle hold, he finally opened wide and latched (after
> many tries) for perhaps a  minute - and then "fell
> asleep" ; when  we detached him he screamed furiously.

Has mother's positioning (considering large breasts) possibly made him feel pushed into the breast, giving him a feeling akin to being held under water?


>              >>Calmed with a finger. Tried cradle hold with nipple shield -
> would not open wide enough. Went to football hold with and without shield.
> 

I was going to ask about a nipple shield. It isn't clear to me how much the breast is offered with and without the shield and whether his response varies to with vs. without.


>   Digital suck exam was interesting. This baby has the longest
> tongue I've ever seen --
>            he can stick it way out, probably 1/2 -3/4 inch beyond gumline.
> When I placed a
>            finger in his mouth -- I don't know where the tongue went. It
> wasn't hiked up in the back,
>            it came just behind gumline as he sucked. Palate is nicely
> arched but maybe a little longer
>            than most. Mom says her last baby also had a long tongue.
> 

(I thought my formerly BF grandson probably has the world's longest tongue, but I could be wrong!)


>            Baby slops milk out of his mouth with his Avent nipple. (Which
> parents are now using
>             to feed him.) We calmed him down with 1/2 oz by bottle >

How is bottle-feeding with the Avent approached? Are feeders reinforcing BF behaviors, e.g. eliciting rooting and wide gape prior to latch being reinforced? I find most parents don't think of this unless I bring to their attention.

Many MOM use the Avent teat but several lately are telling me they were glad when they switched to the Haberman.

Has newborn OT or CST been suggested?


> I tried the archives - we have been remarkably unhelpful with these cases
> over the years! I suggested to mom that time would probably help as the
> mouth would grow. That seems to be the only advice we've 
> given about these

I've known a number of MOM whose babies were born after 36 weeks who have struggled with this type of situaiton for 2-12 weeks before it completely resolved. I tend to focus on preserving milk production, practice breastfeeds with the idea of no pressure to perform and stopping if either party gets really frustrated or baby keeps falling asleep, feed the baby with a teat and techniques less likely to be compatible with eventual BF, and lots of skin-to-skin so baby learns the breast is a pleasant and pressureless place to hang out. I also suggest having a helper for some/many alternative feeds (with instruction on BF-reinforcing technique) so mom can focus on what she needs to focus on without becoming increasingly overwhelmed. In my experience, perspective (hard to come by in the eternity of each day of early postpartum), patience and persistance wins out UNLESS there is an underlying feeding issue unrelated to BF, per se.

Hope that helps a bit...

Karen
> babies.