Alicia

Sounds tricky.... but you don't mention the baby's birthweight, or 
her current weight, so it's not possible to work out how much she 
should take either by breast or bottle.  Also, how much is mom 
currently offering by bottle, say, in 24 hours?

Pamela Morrison IBCLC (who needs info about how many ml/kg/day a baby 
is taking, and her weight history in order to begin to work out why 
she's taking so long to feed)
Rustington, England
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Date:    Sat, 16 Jan 2016 17:11:05 -0500
From:    Alicia Simpson <[log in to unmask]>
Subject: Severely disorganized suck

PTP. Infant is 11 weeks old, born via emergency c-section at 34 weeks due
to low amniotic fluid. Immediate breathing difficulties followed by a
collapsed lung. Fed via nasogastric tube with EBM for first 16 days of
life. Then transitioned to a bottle before release from the NICU. Infant
was being fed 3-4 ounces in each bottle. NICU told mom that pediatricians
and lactation consultants would tell her that it was too much but it wasn't
(sigh). Of course infant is gassy, spits up frequently the usual
overfeeding issues. On top of that it takes her 45-90 minutes to finish a
bottle. She will nurse but does so for the same period of time after which
mom reports that infants wants to eat more. Meaning that a combination of
breastfeeding and bottle feeding can take up to 3 hours! Upon examination
infants suck is highly disorganized, she has a posterior TT and ULT. In
working with baby she does appear to have good tongue mobility despite the
posterior tie but she cannot maintain a semi-good suck for more than 2
small sucks. At 11 weeks I am the first person to work with mom/baby dyad
on nursing. We are working on suck training and moving from bottles to
finger feeding but there is definitely a long road ahead and mom is not yet
open to revisions on TT or ULT. Any suggestions on this case would be
highly appreciated.

Take Care,

*Alicia C. Simpson MS, RD, IBCLC, LD*


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