Hello!

I am nursing a little 2,5 month old baby boy at work who was born at 41+ 
weeks and has a Prune Belly Syndrome. He have had serious problems with 
breathing since the birth and was over a month in ventilator at NICU. He was 
extubated at 10th of September and have had a tracheostomy since. He is 
having serious problems with eating ie. he is not eating at all. He 
obviously had a very tight tongue tie which was treated 2 weeks after the 
feeding attemps had been started (about 3,5 weeks ago). His mother is 
pumping about 1/3 of his milk. He is fed with ng-tube. He cant swallow 
normally (swallows salive though) and does not control normally breathing, 
sucking and swallowing during feeding attemps. He does not suck a pacifier 
either, the mother said that he sucked a paci better before oral feeding 
attemps started. I think the baby is shutting down from feeding attemps. 
Babys neurological status is not clear yet, but there seems not ato be any 
major issues. The baby is alert and responding. The Prune Belly is usually 
not connected with neurological disorders.

Speech therapist is involved, we are going to try thicken the milk next. We 
are doing a lot of stimulation to his lips and mouth and he likes to suck 
mothers finger or his own hands, but not a bottle with milk. (The feeding 
attemps were stressful for the baby at first since they did not teach mom to 
do it right at first weeks in another hospital. The baby was transferred to 
our unit about 2 weeks ago and I got worried when I saw how the baby acted 
during feeding attemps and talked about it to the pediatrician and got 
speech therapist involved.)

Tonight the father asked me whether her wife could try to breastfeed the 
baby. I said that I think it could be possible if the mother is willing to 
try. I am now asking, do any of you have experience with helping a mother to 
breastfeed a baby with tracheostomy?

I have been thinking the whole weekend about trying skin to skin. When the 
baby came I asked the mother about pumping, kangaroo care and breastfeedign 
for comfort but the mother did not seem interested so I did not push them. 
We have been working with feeding  for two weeks now and we have not seen 
much progress so I am thinking s2s again as a treatment for feeding 
difficulties. How to put a baby with a tracheostomy to s2s?

Worried,
Pia Ruohotie, RN and breastfeeding counsellor and educator
From Helsinki, Finland, Europe 

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