On behalf of an acquaintance elsewhere I am asking for input.  Mother has
approved this post.  Baby is now 3 months, had shown strong and increasingly
aversive reactions to attempts at breastfeeding from the start, and has been
finger fed expressed milk for the last 5 weeks or so when attempts at
bringing her to breast seemed to provoke even stronger aversive response.
She accepted finger feeding well.  Co-bathing has been tried and baby seemed
to like it, relaxing more in contact with mother's body, though not actively
rooting or attempting to latch on breast.

Growth is good, baby seems contented, and enjoys skin-to-skin contact.  She
started spontaneously sleeping up to 7 hours at night recently.  For about
the last couple of weeks she has been taking the breast in her mouth for
very brief periods (seconds) without getting upset, but not doing any
nutritive suckling at breast yet.  Milk supply is fine, parents are
satisfied with feeding method for time being.

Baby has not had a bottle nor a pacifier.  Nipple shields were tried briefly
around 3 days after birth because baby would not take breast, but baby
latched poorly on shields and didn't seem to like it either.  On 4th day
baby did take breast without shield but engorgement and jaundice combined to
make it painful for mother and unsatisfying for baby, and it was decided to
take a break from attempts at breastfeeding during which time baby was cup
fed EBM.  Unfortunately baby would not come back to breast afterwards and
attempts to offer the breast were met with increasingly determined refusals
on baby's part.  Shields have been tried again before instituting finger
feeding, and baby was uninterested in latching on them.
Baby has for a long time been happy to suck on her own hand/fingers, and
will lick or suck on mother's (and father's) skin, just not on the nipple,
though over the past couple of weeks she has progressed in this area, as
described above.

Things that are being tried now, in hopes of making progress toward the goal
of feeding at the breast:
-offering breast with feeding tube either when baby is awake, calm and
interested or after a few minutes of finger feeding, to encourage baby to
latch and drink, thinking she may continue once the milk is flowing from the
breast as well
-offering breast with or without feeding tube when baby is drowsy, by
bringing her to breast at least half an hour before next feed is anticipated

-ample time skin-to-skin between feeds with no pressure on baby, letting her
set the pace and respecting her signals.

If anyone has any suggestions for other interventions that may expedite the
process, we would be grateful to hear about them.  We would also be
interested in hearing others' opinions about what to expect next.  Issues in
connection with the birth and the immediate post partum period have of
course been addressed, hence the strategy of letting baby set pace and
respecting her boundaries.  My own feeling is that they are on the right
path, and making progress, and I am optimistic about getting this baby to
breast eventually, but we are grateful for any comments or suggestions.
Rachel Myr
Kristiansand, Norway

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