Hello all,

I would love to have some input from some of you experienced Lactnetters.  

I have a mom in my support group who has a 5-month-old son.  She has struggled from the very beginning with breastfeeding.  (I have her permission to post).  Her son was born at 38 weeks and had great difficulty latching in the hospital.  His birth weight was 8lbs, 1oz and he lost weight down to 7#3oz and was having trouble regaining his birth weight.  She worked with an LC who determined that he had an ineffective, choppy suck.  They were able to get him nursing effectively (meaning simply that he was able to transfer milk at the breast) with a nipple shield.  While he was nursing and did begin to gain weight, there were still many problems.  He is a very sensitive baby and refused to nurse in any position other than cross-cradle.  He also refused to give up the nipple shield.  He was never(and is still never) calm or still while nursing.  He thrashes and arches and fights his way through every feeding.  I met the mom when her baby was 2.5 months and she began attending my weekly support group.  At that time they were still using the nipple shield and nursing cross-cradle.  Over a period of weeks she was able to discontinue the nipple shield, but nursing became very painful for the mom.  The baby clamps down and does not take in enough of the nipple.  I suggested that she see a local lactation consultant.  She had two to three visits with two of the LC's (both IBCLC).  The mom says that one was unable to help her and referred her on to the second.  The second LC she saw suggested she see an occupational therapist to help re-train her baby to suck properly.  After a 6 week wait, she finally had her appointment with the OT last week.  The OT basically told her that the baby takes a bottle fine, so she should just stop breastfeeding so that the baby will gain weight.  He is on the low end of the percentile charts, but since regaining his birthweight, his weight gain has been steady but slow and is within normal limits.  (Birth weight - 8lb1oz, weight at 1wk 7lb3oz, weight last Tuesday at 21 weeks  - 12lbs4oz)  The mom was devastated that she had spent $400 just to be told to give the baby a bottle.  She is determined to continue breastfeeding, but is also weary of the constant struggle to nurse.  I have had many opportunities to observe the baby nursing and he kicks, flails and arches his back throughout the entire feeding.  His latch looks good from he outside, but mom is constantly sore from his clamping down on the nipple.  I have told her that I do not have the experience to "fix" things for her, but that I would try to find all the information I can to help her.  

Other pertinent information:

The baby has severe reflux that caused him to be re-admitted to the hospital at 1 week because he would stop breathing while refluxing.  He was on zantac and reglan until 3 months.  At 3 months mom took him off reglan (after discussing with her pediatrician) because he would not sleep for more than 30 minutes at a time and was only sleeping a total of about 8 hours per day.  His sleep greatly improved after the reglan was discontinued.  

The mom has taken the baby for chiropractic adjustment 3 times so far and has seen improvement in his motor skills but not in nursing.  He was previously unable to lift his trunk while on his tummy and had not yet rolled over at 4 months.  After 2 adjustments he was lifting up on his arms and raising his trunk when on his tummy and he began rolling front-to-back.  

The mom is willing to pursue whatever will help her baby be comfortable.  She is understandably reluctant though to seek more professional help and spend more money just to be told there is no solution.  She is afraid that the behaviors during nursing are a symptom of some further problem that might have been missed if she were not nursing.  I have given her the information on hypertonic babies from the Breastfeeding Answer Book and she is going to try some of the recommendations given in the book.  

I would appreciate any input you may have.  I am sure I have left out some important piece of information, so feel free to email me if you have questions.  I want so much to see this mom happily and comfortably nursing.

Thanks,
Mellanie Sheppard IBCLC hopeful 2004
Arlington, TX USA
For Babies Sake Nursing Moms Group

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