Hi Jessica!  Could it be that the baby is frightened to take anything (breast or bottle) because of a fast flow?  The mother may have a super abundant milk supply (baby took 85cc in 5 minutes).  Are the BMs green, with mucus?  That might indicate an intake of a lot of foremilk and little hindmilk, which would go along with the way the baby is feeding.  Despite little feeding, the baby is gaining; does not seem to have any other issues.  My suggestion would be to try block feeding if the supply is the issue, while  keeping an eye on the number of BMs and weight gain.  If it is a super supply issue, the baby’s suck would not have to be strong or organized.  Perhaps another check for a subtle tongue-tie would be helpful.  If possible, the mom could try to cut down on pacifier use as it may be contributing to incorrect sucking and, eventually, stop its use completely.  Suck retraining might help…if the baby tolerates it.

Jessica, you may have tried most of the above; I am thinking of starting to check everything again.

Does the mom have any help with the 7 other children?  Family, friends, community helpers?  Let’s keep in touch to see if anything helps and/or think of other things to try.

Warmest regards,

Lee Galasso, MS, LLLL

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“Children Are Born with the Need to Breastfeed”

Formula feeding is the longest-lasting uncontrolled experiment in the history of medicine.

~~ Frank Oski, MD; Chair, Department of Pediatrics, Johns Hopkins University, 1985-1996

 

 

Original message:  Just saw a baby girl today, 15 weeks old, because mother said she is refusing to nurse or take a bottle, and will only eat in her sleep, sometimes.  This is the mother's 8th child.  She has nursed them all.

 

Baby born 3.500- 36 hour birth that ended when they were about to put in an epidural at 4cm, and as they were preparing her back, she felt a contraction, jumped to 10 and within 8 minutes the baby was out.  She nursed on the delivery table.

 

On day 1 the baby turned blue and had to be suctioned.  She was under observation for 24 hours.  Already by day 2 they were complaining in the nursery that the baby would not take a bottle or formula.  The mother nursed.

 

By day 8 the mother took her to the ped to complain she was not nursing well .  Ped checked and said all was fine and she was gaining weight.  She has already seen 3 other IBCLC's with no help.  

 

Since then, things have been pretty poor.  Mother described her as just a poor nurser.  She felt her suck was just not very strong or organized.  She went to Cranial Sacral 6 times, the practitioner said her neck was tight and such was unorganized.

 

Now the baby is 15 weeks and 5.740 kilo.  She looks fine.  Cute, happy until

you try to feed her.   Does not appear to have any sensory issues,

interactive, cute, and gaining weight all from sleep feeds.  When the mother tries to bring her close to nurse she turns the other way and screams.  Does the same with a bottle.  The only thing that calms her down is a pacifier which she sucks superficially.

 

On digital suck exam, normal palate, no tongue tie, she follows stimulation by finger.  The only thing I would say is that when tapping on her tongue or stimulating around her mouth she seems under stimulated.  

 

She is meeting all her milestones. 

 

Every feed takes ages.  She has to try for like 45 minutes, then the mother rocks and shakes till she falls asleep and then in her sleep switches the pacifier for a breast, she will take no more than 5 minutes (this time she ate 85 cc in that time) then realizes what she is doing, wakes up and refuses second side.  

 

Mother says she is always on edge due to borderline hunger.   And the mom

can get nothing done because she spends her day and night trying to wait for the right second where she may not realize and eat.  

 

She loves her bath and complains of no other possible sensory issues.  No stuffed nose, loud breathing, does not snore at night. 

 

Good muscle tone,  etc.  No spitting up or signs of reflux.  Mom tried allergic diet, going off of wheat, milk, etc.  for two months and it made no difference.  

 

Help!!! I cant make any sense of this.

 

Any thoughts?  Mother is at her wits end and ready to stop pumping because it is so stressful.  She knows nothing is better with bottle and formula but is really maxed out now.  Remember she has 7 other children to deal with!!

 

Thank you for any thoughts

Jessica Billowitz, IBCLC 

Israel

 


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