My latest little non-latcher was born to a mom w/ large, inverted nipples.
One nipple has gradually everted with prenatal shells and postnatal
pumping; the other still requires the large glass flange to extract any
milk at all, tho it leaks plenty. The baby was only 6 lb 9 at birth, and
couldn't manage a latch. The parents cup-fed, then finger-fed with tubing
for the first 2 1/2 weeks. Mom's nipples are way too large for the small
breast shield, and baby couldn't extract any milk using the large shield.
The baby finger-fed poorly, never achieving a consistent suck-swallow
pattern and taking a long time to feed. So a few days ago we switched to a
bottle. She couldn't figure the Munchkin out at all, and had fits over it.
I had a HealthFlow with me, too, and with some coaxing and dancing around
the room, she finally accepted a big mouthful of it. Ta da! The first
sustained suck-swallow pattern I'd seen her have - beautifully coordinated,
great jaw motion.
They said she was fussy with the bottle, though, screaming whenever it was
removed or "paused" (milk tilted out of it to give her a breather) yet
seeming to overfeed and swallowing more air than they were used to if it
was left in place. They felt she was calmer with the finger-feeding. I
suggested they go with the apparent overfeeding for a day or two, presuming
that she didn't *like* losing the bottle and didn't *care* about losing the
finger.
Sure enough, feedings settled down somewhat... and they called this evening
to say that baby has been latching at bare breast today, periodically
achieving a good suck-swallow rhythm and definitely enjoying herself.
We still have bugs to work through (mom was sore, baby wasn't consistent,
latches were difficult, position was awkward, and at 7 lb 5 the baby is
still rather small compared to that nipple), but they've come a *long* way
very quickly. And their strong feeling is that it was the bottle that was
the breakthrough, not the baby's growth - that the bottle taught their
daughter what sustained nursing was all about, in a way the finger-feeding
had not. I suspect they're right.
Diane, MS, IBCLC, heretic in Ithaca, NY
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