Debbie,
You are right to approach this in a "very soft-sell" manner. Try to look beyond the fact that he had these cleft issues and approach him like any other baby who has not learned to latch. From what you described, baby was just too tense to attempt to latch. Allow mom to nearly fully feed him in the easiest manner (bottle), then take a break to cuddle or burp him while gently easing him down to the breast. He may doze there or just snuggle, but reassure mom that THIS IS PROGRESS!! He may even start to root around and look for more to eat, very sleepy and unaware that the only food source near him is MOM.
As long as he is relaxed and willing, you can let the latch attempt continue. The minute he gets upset or frustrated, remove him from the breast area and let mom just comfort him. She can then try again if he is calm. Just don't try too many times if frustration is building for mom or baby. Remind mom that the baby will latch IN HIS OWN TIME. It may take one or two days, or one or two weeks....or more. But, as long as breast time is happy time, chances of success are increased!
I hope this helps!
Mary Griffin Kellogg, MD, IBCLC
>
> From: Debbie Gillespie <[log in to unmask]>
> Date: 2005/10/26 Wed AM 12:59:57 EST
> To: [log in to unmask]
> Subject: Re: Cleft Palate and Breast-feeding
>
> Hi folks,
>
> While we're on the subject, I was hoping you wise people might be able to
> share some of your experiences with getting a baby back to the breast after
> having cleft lip and palate repair surgery. I'm working with a mom and her
> 10-week-old son who just had the repair surgery two weeks ago. Prior to the
> surgery, mom was feeding him EBM in a Haberman feeder (this smart young mom
> visited an IBCLC while still pregnant). After surgery the staff gave her a
> squeeze bottle with a skinny rubber nipple and she hasn't used the Haberman
> since. Mom says she tried an Avent nipple after surgery but she thinks from
> the way he reacted it irritated the roof of his mouth; maybe a rubber nipple
> is softer and less aggravating than silicone?
>
> His upper lip has just one stitch left to dissolve, but still looks
> considerably stretched and turgid compared with untouched babies' lips. The
> palate feels slightly bumpier than an untouched palate, but I don't believe
> it will cause any irritation to mom. He even managed to cup his tongue and
> lightly suck on my (gloved) finger during the exam, which was very exciting
> to his mom and I. He's healing beautifully but needs to regain .5# he had
> lost during the surgery and recovery.
>
> I showed mom paced bottle feeding, hoping that encouraging him to work at
> getting the milk out of the bottle would be a good first step in teaching
> him how to suck. The baby took to it really well for a few minutes,
> extending his tongue and cupping the (skinny) bottle nipple. Then he
> refused to close his mouth around the nipple in any position, so mom was
> thinking that he needed another dose of ibuprofen.
>
> We tried latching baby on just to see how he would react, but it didn't go
> well. He is easily upset and he was outright wailing before we could
> position him. Mom said he briefly breastfed once shortly after surgery,
> while he was still getting the heavy-duty painkillers...but he DID feed!
>
> In that light, I'm hoping a very soft-sell approach (lots of sts, carrying,
> warm baths, lying on mom's chest, etc.) will help warm him up to the idea.
> Meanwhile, I was hoping some of you might have some suggestions for bottle
> nipple types, OT/PT exercises, etc., we can use to gently coax him back to
> effective breastfeeding with an effective suck. I searched the archives but
> found very few ideas. Thanks a million in advance for any tips you can share.
>
> Debbie Gillespie, rookie IBCLC, LLLL
>
> ***********************************************
>
> To temporarily stop your subscription: set lactnet nomail
> To start it again: set lactnet mail (or digest)
> To unsubscribe: unsubscribe lactnet
> All commands go to [log in to unmask]
>
> The LACTNET mailing list is powered by L-Soft's renowned
> LISTSERV(R) list management software together with L-Soft's LSMTP(R)
> mailer for lightning fast mail delivery. For more information, go to:
> http://www.lsoft.com/LISTSERV-powered.html
>
***********************************************
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html
|
