HELP!

I just received a phone call from a patient I worked with in-patient last
Thursday night (9/2/99).   Unfortuneately since she was not my assigned
patient I was only able to spend a couple of hours working with her.  I don't
have all of her birth info here but to the best of my recollection her little
boy was born Wednesday night at 2200. Uneventful, UNMEDICATED delivery.  A
variety of nurses worked with him the first 24hrs to get him to latch but he
just would not.  She has small firm breasts with completely normal protruding
nipples, soft areola.  The first night/day he was gaggy, spitty, and was deep
suctioned x 1.  I was able to get him to latch for only brief periods and
most successfully with mom on her back and baby on his tummy which enabled
him to get a deeper latch and trigger sucking.  He will suck on a finger with
a well coordinated suck.

I recommended that she spend the next 48hrs(after DC home) pretty much naked
with him in bed to encourage lots of positive at the breast time (instead of
nurses forcing him..) and I had hoped that he would latch in his own time.

Well she has been pumping every two hours, feeding via dropper 2 oz q 4hrs,
and attempting at the breast both when hungry and/or in the middle of the
feeding to no avail.  She says he is less interested in suckling at the
breast now than last week.  To top it off she spoke to a LLL who told her he
needs immediate neurological workup which scared her.

I've suggested possibly a breast shield (which I ordinarily NEVER use) and
maybe CST (he has a cephalohematoma on R).

I am open to ANY suggestions.  She is taking him to Ped in am.  I can see her
tomorrow afternoon after I sleep!  I know virtually nothing about CST other
than what I'm learning from you all.  Is there anyone in Orange County,
California that does this????

sorry this is so long... Thank you in advance for your help

Liz Benbrook, RNC, IBCLC

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