PTP. I have been working with a mother, strictly by phone, on many different issues. She cannot afford to come visit and other options have not seem to be workable either. Her 5yo child has autism and now with her second, she is recognizing many similarities. She has struggled with breastfeeding and low milk supply. She is very committed to providing exclusive breastmilk. Infant has been difficult, per her report, to latch. She will only get one dream feed a day in. She has been pumping and proving EBM via bottle.
     One question is bottle nipple type. She has tried Medela's Special Needs Feeder and other bottle nipple types and says infant collapses the nipple. Infant does best with Enfamil's standard flow nipple from the hospital. She is asking for other ideas. We have discussed Pigeon and Dr Brown's Specialty feeder. 
     Also, she states she feel that this infant has a form of sensory intergration disorder. Long story, multiple tongue tie revisions. She stated that infant will not drink milk unless a certain temperature. If the milk cools while burping then infant struggles with the bottle. Mother is looking for any innovative ideas to keep milk warm. She says she cannot go out because she cannot keep milk warm enough and is considering a steel thermos type of container for transportation. Anybody know someone who makes a bottle coozy( ala what is used to wrap beer or soda to keep cold)?
    We have also discussed speech therpay needs. We have had many discussions.....

TIA,

Allyson Michaels, RN, IBCLC
Charlotesville, VA

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