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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