Hi:

This is an update on the mom I posted about several days ago.  I gave a 
detailed history and suggested care plan.

What has helped the most:

Same side feeds - went from gaining 3 oz per day last Friday to 2 oz per day 
as of the following Wed. 5 days later.

Positional changes.

Purposefully taking baby off at the start of MER ( mom clearly felt 3 per 10 
minute feed - caused her a lot of pain when it happened), and allowing milk to 
spray for minutes at a time if necessary.

Changes:

Went from baby choking and sputtering from 3 feeds per side to 2 to 1 breast 
per feed as of yesterday.

Went from blood in vomit, projectile vomiting or spitting up and arching back 
and crying hard after every feeding to now only 3 feeds a day with this 
occurence and the reaction is about 50% less than it was a week ago.

Significantly less painful MER and very manageable.

Tried baby without nipple shield this morning and baby latched on with little 
fuss and mom says it was a very calm feeding and when MER happened, it had 
been feeling less intense so she just let it happen and baby seemed to handle 
flow very well.

This mom went from wanting to quit breastfeeding one week ago because of 
severe pain from MER and because of difficult breastfeeding behavior - pain 
and projectile vomiting on babies part, to being very happy one week later.

I want to thank you for the responses I received.  While I had suggested that 
she remove baby when MER happened, she did not really want to as she saw 
this as being almost mean to baby and could not bare to do that.

I deleted all personal name/email, dates, etc. except for the first name - of 4 
posts I received of list members that either dealt with this personally and/or 
with a client.  Each post suggested to take the baby off.

Mom sat with that post for one full day and actually told me later that she got 
a bit made at me for intially suggesting it and then forwarding these posts to 
her.  I intuitively just felt they would help.

She thought about it one day while relaxing in the tub and next feed began 
following this advise.

Other advise I gave her helped tremendously and while I believe it would have 
eventually worked its way out, I am not sure if she would have stuck it out 
that long.  I believe that once she knew who the postings were coming from ( 
experienced Lactnet Members) that held a lot of validity to her and she 
decided to listen. 

You all really helped me with this mom and I thank you.

Lori J. Isenstadt, IBCLC
www.aabreastfeeding.com
Peoria, AZ 85382

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