Hi.  This is my first post after lurking for the past year.  My name is Beth
Seidel and I am an IBCLC at a hospital with about 500 births/year in central
Illinois.  I have been employed in this position for 2.5 years and see both
outpatient and inpatient mothers.  I am the mother of two children, 7 and 4,
both of whom I breastfed, my first for 14 months and my little one self
weaning as she turned 4.  I am working with a mom and babe who have me
stumped so I wanted to see if I might collect some wisdom from all of you.

Baby was born on 8/3/99 by planned repeat c-section with a birth weight of 7
lbs 4 ozs.  By day 6 she had dropped to 6.5.  She had a tight lingual
frenulum which was clipped on day 7. (She also has a bubble palate) Baby
would not stay attached to breast prior to the clipping and in the short
moments that she would latch, mom reported considerable nipple pain.  I
first saw this baby at the time of the clipping and she did latch on
immediately afterwards.  Mom stated that her nipples felt good, baby sucked
continuously for about 15 minutes, mom's breast had considerably softened
after feed so we thought things were going well...mom was compressing her
breast throughout that feed.   I next saw mom and babe 3 days later when mom
stated that she had started pumping again and was bottle feeding as baby had
stopped stooling.  She stated that the baby was taking 45-60 minutes to
drink 2-3 ounces and appeared to be chewing the nipple rather than sucking.
 A pre and post feed weight showed no milk transfer, despite the fact that
babe sucked continuously at breast and appeared to be swallowing.  Mom has a
good milk supply, she pumps every 2-3 hours and produces from 6-10 oz in 15
minutes.  I watched the baby bottle feed and she does not suck, she only
chews and is VERY slow.  I encouraged mom to suck train babe with her finger
but the baby screams when mom puts her finger in babe's mouth and will not
suck on it.  She would latch onto my finger but again she only chewed.  I
tried the CHARM hold with her but even then she does not bring her tongue
forward.  Babe is gaining great with pumped milk. Mom had the same
experience with first babe...no weight gain at breast and slow bottle
feeding.  With that baby, she did not pump and fed ABM.  She is determined
to give this babe breast milk.  I would love to hear any ideas because there
is obviously something going on here that I don't know about yet!

Thanks much!
Beth Seidel, IBCLC

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