Hello Everyone,

My name is Jamie Stouffer - I am the mother of 2 children (10 and 2.)  I have practiced as a midwife for the past 5 years although in the province I live in I can no longer legally call myself a midwife.  We have gone through a legalization process and I have opted not to do the assessment and upgrading program at this time.  I am continuing to attend women as a professional birth assistant and counsellor.  I am also studying homeopathy and hope within 3-4 years to be ready to begin practicing on people outside my own family and circle.

I have had contact with a woman (a client of my friend) who is having much difficulty breast feeding.  This is her first baby. She has severely inverted nipples and large breasts.  Her baby (born after a basically normal birth with no forceps/vaccum but longish pushing stage with a nurse who manipulated the head some) has a tiny little mouth.  He is coming 3 weeks now and has yet to really nurse.  She has had him at the breast from the beginning - and continues to try him many times daily.  He has latched on a couple times - but sucks 3-4 times and then simply hangs there.  She is pumping and feeding him primarily with breastmilk although last time I was talking to her she was thinking about supplementing because he seems to be hungry all the time.  He is gaining weight and has 10 - 12 wet diapers daily.

What we are doing / have done:
We have recommended that she keep him close to her - carry him in the sling etc.
We have recommended that she try nursing him every time he seems interested and/or several times a day.
We have recommended that she use the pump to pull her nipples out before she nurses (has done this - they last a few mins and he usually misses it)
We have recommended that she take him to see a chiropracter and have his neck/jaw adjusted (he has quite an over bite)
We have told her to pump often (every 2 hours not being too often)
We have told her to focus on the wet diapers and weight gain as an indication of his well being rather than the actual amount he's getting from a bottle.
We have informed her that it may simply be a matter of waiting until his mouth is large enough to accomodate her breast.
We are working on getting her a better quality pump.
We have suggested fenugreek to increase milk production.
We have recommended that she avoid bottles and use a cup or dropper to feed the baby.   She has been using a bottle the last while because he was gagging with the cup.  We will try to get a lactaid to her this week.

It seems like there's more that we've tried/recommended/suggested - but that's all I can think of right now.

I have helped women with inverted nipples before - and first time moms - but  woman is having much more difficulty than anyone I have seen before.

Anything further that anyone could offer would be greatly appreciated.  She is very dedicated to breastfeeding but she's getting tired and frustrated.  She contacted LLL in her area and was read to from the manual (she has read everything herself that she can find on the matter.)  She had 8 different nurses, a public health nurse and
 a lactation consultant manual manipulating her baby's head and her breast in the first 2 days after the birth.  She really doesn't want to deal with anyone else - or tell anyone else her story.  I will be going to the city tomorrow - and will most likely be able to see her over the next 2 weeks often.

Thanks much in advance.  Looking forward to an overwhelming response. *smiles*


Regards,
Jamie
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