I have permission to post this question from a patient I consulted on as an
outpatient today. Her baby is 8 weeks old and was born at 37 weeks. She
had trouble latching during the hospital stay, but went home both attempting
breast and pumping. The mother complains that baby is hurting her during the
feeding and she can only stand to nurse once in the morning and once in the
evening. All other feeds are done via bottle with a standard nipple and mom is
pumping. Her anatomy is WNL, nipples mod large. I performed a digital
assessment prior to the latch and the baby was gaggy and mostly bit down on
my gloved finger. Baby was able to latch, I did hear swallows but baby never
did get rhythmic. Compression during feeding did not change the pattern and
mom reports changing positions does not help either. After the feed, baby
took a standard nipple with bottle fine. I did try the nuk nipple hoping to make
the baby have to draw a little more than with the standard nipple. I feel that
maybe baby would benefit from a speech consult as well if this infact is truely
a suck issue. Is there anything else anyone could recommend before I would
get speech involved? Thank you all in advance as I am new to the outpatient
world and am learning everyday.
Rachel RN IBCLC
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