Dear Lactnetters
               I have a baby of 8weeks who is still not able to suckle
efficiently at the breast. Mother has large nipples, about 2cm long and 2cm
diameter with narrowing of the diameter at the base, like a constriction
ring.
In the first few days we had to work on getting him onto the areola not just
the nipple but mother soon mastered that. His suckle is very gentle and
rapid with almost no drawing action. With long breastfeeding sessions with
breast compression, he just did not have any weight gain.
At 2weeks, I introduced expressing and the SNS. This worked well with good
weight gains. Now at 8 weeks, mother is still expressing and he is still
requiring 100mls of EBM through the SNS. I expected that as he grew(now
4.500kg) he would be able to accomodate the nipple and breast and suckle
effectively. He has mastered the art of drawing the milk from the SNS but if
it is turned off he reverts to the gentle rapid suckling. THe parents give
him one bottle at night using the long teat. This session took 45mins up
until 2 weeks ago, his suckling was quite disorganised. It now takes only
10mins.
Any ideas of where  we go from here.
Thanks
Robyn Dunning NZ
RGON, RM, IBCLC

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