Hello wise ones,
I'm in the middle of a move, so if replies could also be cc'ed to me privately I'd appreciate it [log in to unmask] .
Posting with permission from the client.
Twin boys born at 39.5 weeks gestation, pitocin induction, 15 hour labor, epidural at 10 cm (don't get me started...). Twin A: 6'4", apgars 8/9, twin B: 5'9", apgars 9/9. Both were suctioned with a bulb syringe as is the routine at this hospital. Both latched within 1 hour of birth. Visit at 24 hours for nipple soreness, checked oral anatomy of the babies which looked fine, corrected some latch issues and mom stated nursing was more comfortable. However, other latch issues arose. Hospital LC worked with her, provided lansinoh and showed her how to tandem nurse them. Once home mom's milk came in on day three, supply looks more than ample, but nipple soreness returned. I was unable to make a home visit that evening so her postpartum doula who is also a lay breastfeeding counselor worked with her, consulting with me on the phone. Nipple shields were provided, the babies won't latch with them at all. Pacifiers were tried for 24 hours on approximately day 7, and then laid aside in favor of parents soothing by offering a finger for sucking. On day 10, nipples are no longer sore. Baby A latches and nurses well. Babies are fed approximately every 2.5 - 3 hours, usually they have to be awakened to nurse. Baby B sometimes latches and nurses well BUT sometimes will not latch at all. Mom's nipples are perfect for breastfeeding. Her initial engorgement has subsided so she no longer has taught breasts. There are feeds when baby B will not latch at all. Mom is very patient but baby doesn't seem to recognize that a nipple is in his mouth, he won't close and suck. Sometimes he will suck once or twice, then slips to the end and delatches. If she can't get him to latch he is finger fed EBM and mom pumps after the feed. We tried different positions, nursing more at a shorter interval (he wouldn't latch and remained very sleepy), individual nursing, finger sucking to calm, very small finger feed to calm then to breast, swaddling, naked, quiet darkened room, lighter with music room. Both babies had initial weight lose of approx. 10% in the hospital, but are now gaining just over an ounce per day.
Any ideas? Mom is feeling desperate as each feed is taking about an hour.
Thanks for your input,
Warm Regards,
Dawn Martin, CD (DONA), IBCLC
Austin, TX
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