How was baby fed the night under the lights? Is it possible that that was her first exposure to the bottle, resulting in an unwillingness to do the work it takes to breastfeed?
I think this is a situation where a 'bed in' (safely, of course) would be useful. Mom topless, baby in just a diaper. Hang out in laid-back breastfeeding position, let baby nip and nap as much she wants. Keep an eye on diapers to make sure milk is going in. Use something other than a bottle if more pumped milk seems needed or use paced bottle feeding extremely judiciously.
This mom could also benefit from a gentle exploration of her expectations - breastfeeding all the time is what she will be doing even (especially) if all is going well.
Ingrid
LLLL, IBCLC
Original Message
From: Pat Young
Sent: Friday, March 21, 2014 12:35 PM
To: [log in to unmask]
Reply To: Lactation Information and Discussion
Subject: Re: Need help encouraging a baby to nurse!
Bili makes them tired and disorganized. As it comes down she will wake up and figure it out. Tell mom to hang inthere! Pat in SNJ
On 03/20/14, Mandy Ball wrote:
I visited a mom last night who has a 5 day old baby girl, born at 37 weeks and 2 days, 5 lb 1 ounce, no weight loss. Baby latched in hospital, since coming home, she basically plays with the nipple. She sometimes eventually latches and nurses effectively (as evidenced by a weigh feed weigh at my visit). She often spends 40-45 minutes trying to get her to suck and eat. Mom is frustrated and feeling defeated. Baby takes a bottle with no trouble. She often gets frustrated at the breast and cries, but mostly just plays and doesn't effectively suck. It took her about 35 minutes last night before she latched and nursed taking a little over an ounce (about 40ml).
I tried a nipple shield to see if that would encourage her latch, but no success. A little history, The baby also has a bili level of 13 and developed the disinterest/troubles after spending a night under the bili lights the last night in the hospital.
Does anyone have any other suggestions I can give this mom? I just talked with mom and as she was crying, I encouraged her to keep offering the breast and giving the baby "practice" at feeding, but not to feel discouraged if she has to give a bottle. Mom has a great supply, flows freely when she is trying to get the baby latched. Mom can pump 2 ounces from one side in about 10 minutes. Supply is not an issue! No tongue tie and Her positioning is great and should be conducive to nursing, I cannot figure out why the baby won't suck!
Thanks!
Mandy
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