I don't know if it's too late for this tidbit, but I recall hearing at the
Wolf and Glass Conference I attended a few years ago that the Nuk
Orthodontic Slo Flow nipple relies more on compression than suction.  After
that I recommended it to a mom I was working with whose baby was having oral
motor problems, and it worked like a charm, much better than even the
Haberman (cheaper too!).  I heard several months ago that Gerber was
discontinuing them, but I just saw some at the local grocery store last
week.

I definitely agree with Kathy when she says you haven't let the mother
down.  If we went to a doctor for a medical condition and s/he didn't fix
it, I'll bet s/he doesn't lose wink of sleep thinking s/he let us down!
Even if we don't have the answers, we have wonderful resources like Lactnet
for more ideas on what to try next and/or where to send her for more
specific care.

It's also a priceless opportunity for us to learn how to handle the
situation when we see it next time.  Ask the mom if you may tag along with
her to her appointment if the baby gets a oral motor/feeding evaluation.
I've done that in the past, partly as moral support for mom, but as an added
bonus, I get to learn what happens during such an evaluation.  When I've
done these, some moms have even expected to pay me for my time (I of course
graciously decline), when in fact I feel like I should pay them for the
valuable learning experience!

Hang in there -- your caring and thoughtfulness probably mean so much to
this mom.

Debbie Gillespie, IBCLC, LLLL
Tempe, AZ


On 3/1/07, Kathy Eng <[log in to unmask]> wrote:
>
> Kirsten, this definitely sounds like an oral motor problem. Most older
> babies can down 3 ounces in a bottle in like 5-10 minutes! The Avent
> bottle can be chomped more easily than other bottles so this may be why
> it is working for this baby. I have worked with some babies that can't
> breast or bottle feed well. A video flourescent (sic) suck swallow study
> could be helpful to see what is going on in the mouth and with
> swallowing. I would try a Haberman Feeder if your WIC can get one. It
> may take the baby 3-4 times with the Haberman to learn how to use it but
> it often helps the baby who can not do bottles well. I find they can
> manage the Haberman in less time and start acting less stressed once
> feedings improve. Some of these babies are later moved to a faster
> flowing nipple by the SLP or OT and mom reports that helps. You have not
> let this mother down -- if the baby can't do it, she can't do it and an
> LC is not usually qualified in this area. You can help this mother by
> encouraging her to pump 8 times a day to keep up her supply and trying
> to find a good SLP or OT to refer her to. A call every week to tell her
> how wonderful she is and what a good mother she is will cheer her up. I
> also find that my HCP report to the pedi describing the problems (not
> diagnosing) and then recommending an evaluation by an SLP or OT is often
> very helpful. I like to watch the mom breast and bottle feed so I can
> describe what baby is doing or not doing to the doctor.
>
> Kathy Eng, BSW, IBCLC
> >
> >
>
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