Hello all,
I am so sorry to not have been able to keep up with Lactnet over the past year. Having been elected to the BOD of La leche League International has kept me up nights just with board work, not to mention the other things keeping all of us busy!!!! But I have just spoken to a mom on the phone with a very scarey case. I would love your input but please reply to my private email as well as the list, of course!

3rd baby, first two breastfed beautifully. No apparent problem with supply.
this baby was born with a small cleft of the soft palate. Has been expressing and baby has been fed on EBM only via Haberman. Born 3.910 and now at 3 months weighs only 4.310. This is a gain of only 400 grams!! (Less than a lb!)

They were hospitalized for the first two weeks of life, and the week after discharge the baby gained nicely so she didn't go back to the baby clinic for a month. When they discovered the lack of weight gain they went through tons of blood tests, thyroid checks etc...and came up with nothing. Now the Ped. recommended to start giving cornflour!
She has terrible pain and bleeding nipples from thrush. and the baby has been diagnosed with thrush. Oral gel brought no relief but the baby's condition improved with nystatin. She has been using the Ameda double sided pump. the Dr. recommended using the oral gel on her nipples which brought no relief.

She says she feels that the baby isn't eating enough because of the Haberman. I asked her if she thought she could increase the baby's intake by EBM, and perhaps switch to a slow flow bottle, upright position and paced feeding. She said she already bought a bottle because she also thought along those lines.

I suggested: using a stronger anti-fungal cream for her nipples to be recommended and rxed by her Ped. to continue according to dr. with the nystatin (does anyone know how long this can be used non-stop?)
switch to a better pump in order to increase supply, and try to feed the baby more milk using feeding method other than haberman. If this doesn't work, i.e. baby gets stressed, doesn't want to eat more than she is eating now, then she just might have to switch to a fortified formula to increase the baby's weight according to her Ped's instructions.

Has anyone had experience with this type of cleft and has bfg been successful?. She would love to bf, hasn't tried with this baby because of fear of failure, and everyone has told her it won't work. But my gut feeling tells me it may be worth trying? 

She will be weighing this baby every 48 hours in the coming days. Anyone have any suggestions?
Thanks a million.

Hope to get back on here soon.

Ellen Shein, IBCLC, LLLI, Tel Aviv


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