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Subject:
From:
Sharon Knorr <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 2 Aug 2001 16:36:58 -0400
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Dear Sue,

Am very busy right now and haven't done much Lactnet reading lately, but your post and a response caught my eye.  No offense intended, but I would be very wary of any strategy involving "forcing" the baby to breastfeed by witholding all other sources of milk.  This baby sounds like he has a real sucking deficit of some kind - you say that he doesn't even suck well on a bottle or a finger and the SNS and shield have both been used with no success.  Witholding the bottle will not cause this baby's problems to suddenly disappear - on the contrary, it may cause the baby so much stress that feeding attempts may even get worse.  This is not to mention the stress on a parent.  Cold turkey sometimes works well with babies who have had no history of suck problems - but it is almost never my method of choice.

I think that a better way to go is to applaud the mother's efforts to provide breastmilk for her child, no matter what the delivery system may be.  You may want to have an experienced colleague help you to do another top-to-bottom assessment of this baby in an effort to discover the root cause of the poor latch and suck.  Then you can devise a strategy which in the long run, will get baby back to breast.  Unfortunately, this is not often an easy or quick process.  It may only involve some creative positioning and support for the baby while breastfeeding or it may need more than that, an SNS, etc.

Moms often get burned out trying a lot of different strategies.  It is often better to go back to the basics and concentrate for a while on maintaining the milk supply.  Let the mom take a little break - no guilt trips about using a bottle (don't see why finger-feeding would be preferable, unless she will be doing suck training in conjunction with feeding).  This is a busy lady with four kids.  Really listen to her for a while and see if you can help her come to a true understanding of what she wants to do and what she feels able to do in order to get there.

Good luck.  I'm not saying that cold turkey absolutely won't work, but I would be very surprised if it did in this circumstance.  You know this dyad better than anyone else, so use your best judgement when making your suggestions.
Warmly,
Sharon Knorr, BSMT, ASCP, IBCLC
Newark, NY (near Rochester on Lake Ontario)
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