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Date: | Sat, 30 Sep 2006 02:03:23 +0300 |
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Dear Mellanie!
I have read your mail and all the answers and thought to share some ideas
and some experience.
You wrote that this is mothers 4th baby and she had problems with the
breastfeeding with the baby number 3 also. What about the first two babies?
Did they breastfeed normally? Can there be any hints for the reasons of this
problem?
What if the reason is not only with the baby but with the mother also? I am
thinking for example the elasticity or the size of the nipples? I have had a
couple of cases where the main reason behind milk transfering problems were
the nipples that were too large for the babies to suckle efficiently. The
latest case was from this summer. The mother had not been able to nurse her
both children for the first 3-4 weeks because her nipples were too large for
the baby even to take them into her mouth. The mother expressed her milk and
fed it from the bottle to the both babies and then gradually babies switched
to the breastfeeding. I worked with the mother with the second baby, they
did not discover the reason with the first baby. The mother thought the
reason with the first baby was because the first baby had infection right
after birth and was bottlefed at the childrens unit but it was not the only
reason as it turned out the second time. This mothers nipples were so big
that we could not even try the nipple shields we have here in Finland.
The second thought was the nipple shield, have you tried it? Sometimes it
helps the baby to breastfeed better when the oral motor functioning is
ineffective or compromised.
I have had one mother baby dyad where the reason was babys ineffective
sucking technique. This mother was able to improve the nursing by better
latching technique and very short intervals between feedings and the weight
gain normalized. But the mother was not able to breastfeed all the time for
months since she had older child, too (normal breastfeeding, no problems
with sucking or weight gain) and the weight gain slowed. I suggested
supplementation or solids according Dr Newman and pediatrician or speech
specialist assesment but the mother chose not to do so (baby was 3 months
old). One month later the baby was referred to the pediatrician and admitted
to the hospital due to slow weigth gain and of course the breastfeeding got
the blame. They switched the baby (about 4-5 months old) to the bottle and
EBM. The mother was able to express twice the amount of milk that the baby
took at a feeding according to the test weighting. The baby continued to
have feeding problems. A couple months later a speech specialist diagnosed
oral motor function problems as the baby had problems with solids and
bottlefeeding also. It was so frustrating and sad how too often the
breastfeeding is considered to be the problem when it is not.
Your clients baby bottlefed slowly, too. Maybe the baby still is having
problems with sucking or is still learning to nurse as others has suggested.
In any way she is doing excellent work by expressing the milk.
Best wishes,
Pia Ruohotie, RN, breastfeeding counsellor, mother-to-mother bf support
group leader
From Helsinki, Finland, Europe
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