I posted a few weeks ago about a baby with breast refusal. The mom has
had no luck getting the baby to breast, even with lots of skin-to-skin
and amazing patience. Pumping is going well for her, she still is
freezing about 15oz/day, so milk supply is solid. I just talked to
her, and the baby has been presenting with feeding difficulties at the
bottle. Baby is 8 weeks old, and still takes about 45 minutes to
finish 3oz from a bottle. She went through a bout of bottle-refusal
about 2 weeks ago, that was resolved by switching bottles (now using
Avent, had been using the Playtex VentAire) and taking away all
pacifier time. I hadn't thought of the pacifier earlier (kicking
self), but in any case, it's gone now.
She goes to see her ped tomorrow, and I am going to call him and
recommend an OT evaluation.
I have a suspicion that once this baby is stronger and can feed more
effectively, we may still get her back to breast, so I encouraged mom
to put baby to breast *after* feeding, let her spend her full-belly
time lounging next to mom's skin to work on positive associations.
Anyway - she does appear to have some basic feeding problem, to be
struggling so even with a bottle. Weight gain is fine, if a bit slow.
Birth weight was 10-0, and she is just now up to 10-14. Lowest weight
was 8-12 (when bottles were introduced and started this whole mess),
and it took her about 3 weeks to return to birthweight.
this baby has not latched and fed at all since Jan 24, when she fed
one time. Mom BF first two babies past a year, so this is very hard
for her.
She goes to a BF support group run through WIC that is helpful.
Other than suggesting more time at breast (not trying to feed, but for
positive associations) and an OT eval - does anyone have any other
ideas to try? I really feel I've let this mom down - she came to us
with some occasional breastfeeds, but the strain of always trying and
also dealing with 2 older kids and pumping was just too much, so she's
been just bottle-feeding and not offering for the past month.
She did offer the breast one time during the bout of bottle-refusal,
but the baby just screamed there as she was doing with the bottle.
What are we missing here?
Thanks!!!
Kirsten Berggren, PhD, CLC
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