Heather writes: 
>OK - I know I am posting from a different culture with different 
>expectations, but I am really taken aback by the amount of 
>intervention that's happened before you saw this mother & baby, 
>Angela....mother got a nipple shield very early on (could she not 
>have been helped to get a position that was effective and 
>comfortable?) and the baby had formula, and was then given three 
>(three!) meds - and the mother puts herself on an elimimation diet.
>And all this in the first weeks :(

Sad isn't it? The interventions started before she even had the baby. No trial of labor was done. Just scheduled a section. We have two hospitals here. One of them sends every breastfeeding mum home with a shield, the other sends almost no one home with a shield. Mom delivered at the latter of the two. He is one of the very few I have seen that really does get a much better latch with the shield. Now, obviously I didn't see him at birth, so I can't say if it could have been salvaged then or not. 

He does have a poor position. His jaw is still assymetric and receeded and I just don't think he can get it foward enough to get that chin, jaw, and tongue in optimal position without the shield. He's getting there, but he isn't there yet. And of course, by the time I saw them, he was refusing to even mouth the nipple without the shield in place. 

After watching this baby arch and scream and fuss and cough, I would say yes, he needs something for the reflux. We are working on getting him to latch without the shield, at least he will briefly latch now without it. Before, he would not at all. She does frequently use the BN position since I showed her, and it definitely helps with the clicking. Unfortunately, he still won't maintain a latch without the shield. And he's still miserable with reflux.

No formula since 2 and a half weeks! (Yay!) Mom has tried the babymoon twice and it seemed to work, but again, a few days later he was right back to having an episode. So again, I don't know if it really worked, or if it was just part of his cycle.

Angela H.
IBCLC, RLC

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