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Date: | Sat, 5 Nov 2005 16:45:14 -0500 |
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Ann,
Could be a shot in the dark here, but I'd be more inclined to think that the
baby might be objecting to the flow rate of the SNS. You don't say why the
baby was a poor nurser to begin with. Using a paced feeding technique, with
baby in a sitting position, and a truly slow- flowing nipple would be my
choice for a baby that was borderline failure to thrive at 23 days. With mom
on a good pump. But if mom is truly opposed to a bottle I'd go back to
fingerfeeding with a syringe and tube or a periodontal syringe. Once the
baby gains some weight it may be strong enough to nurse appropriately.
Perhaps using a nipple shield as a transition tool, if it seems nipple
confused. Without enough calories, baby may not have the energy to nurse
appropriately. I've seen a few babies where I couldn't even do a proper
assessment of their problem until they got some calories into them in a
safe, acceptable-to-the-baby manner. If the SNS is used, I'd try putting the
baby completely on his/her side so milk can be allowed to spill out the
corner of the mouth if baby is overwhelmed by the flow.
Good luck,
Anne Grider, IBCLC
Private Practice
.
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