Dear June,

Sleepy, or drugged babies that don't suck well (or at all) are common here in the US. There are several things that we have discussed on Lactnet in the past:

1. Skin to Skin contact, baby sleeping on mom's naked chest and allowed to wake up next to the nipple. This works well if your hospital is willing to allow babies time to wake up before demanding that they eat. Mom can massage her breasts when baby is latched on, especially if baby will wake up and stay wake. 

2. If the hospital is going to insist baby be fed formula if he does not eat, then supplementing at the breast is very effective at teaching them to suck actively. Mom can hand express some colostrum. Put the supplement in a syringe with a tip (no needle on it or use a periodontal syringe) or put a #5 French feeding tube onto the syringe. I cut the tube off above the little side holes but not everyone does this. Latch baby on, snake the little tube into the corner of baby's mouth, and squirt the colostrum (or formula) into baby's mouth. 

I squirt enough to get the baby going -- usually several drops worth. I look for 10+ repetitions in a row, with a 3-5 second pause before I squirt again. If you are fairly aggressive about squirting, then baby usually responds by swallowing the milk flow and getting down to business. When the flow is going well and baby is transferring milk, he will open his eyes and then relax his arms and hands. Baby will also start having good BMs. 

I had to use the technique alot when I was an L.C. in a hospital because the babies were going to get a bottle of formula if they did not breastfeed good enough. I would be sent in to make the baby breastfeed on day two and most babies had already had formula by then. Most of the time I used 10-15 ml of formula at the breast (sorry!) because the nurses would insist on baby eating at least 15 ml formula. I found the feeding tube and syringe device especially effective for c-section or too early induction babies. Some babies needed it for a day, some needed it for only 2 feedings before they woke up. What I really liked was it taught them to actively suck which is how they remove the milk. What I didn't like was using the formula. 

And yes, it grinded on me mentally that our system of birth and feeding was so invasive and detrimental to breastfeeding.

Kathy Eng, BSW, IBCLC


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