If I had to pick one phrase which characterizes most of my work, it
would be non-latching babies.
I work in a hospital which has 9000+ births per year, 90% epidural
rates, and 22% c-section rates, and I would say that on a normal day,
60% of the babies do not latch. Normal hospital stay 48 hours for
vaginal births, 96 for CS.
Procedures which I have found to work:
1. Encourage moms to take advantage of rooming in which is offered in
our hospital, but not always understood. After I finish explaining to
them how babies feel in the first few days in this foreign place we have
brought them to and how the only place they feel good is on moms chest,
most moms would not think of leaving the babies to cry in the nursery.
2. Skin to skin. Wait for the babies to lunge toward one breast or the
other.
Hand expression of small amounts of milk on a tiny spoon: 5 spoons from
each breast every 2 hours during the day will prevent weight loss, and
maintain blood sugars. The milk I is gently dripped into the baby's
mouth, and the spoon never enters the oral cavity. Hand expression
shows moms that there is milk, and gives her another tool if ever
needed. This must be taught, otherwise many moms will not be able to
express even a drop. This also shows that the milk is not in the
nipple, but deep in the breast and that the baby has to massage the
breast to remove milk, not just suck on the nipple.
I show moms a replica of the size of stomach capacity in the first few
days to show that the baby does not need huge amounts of food.
If anyone thinks that there is a danger of aspiration, I immediately
demonstrate to them the fast flow of the bottle nipples that are given
in the hospital, and this usually shocks them.
3. Rebirthing, i.e. laying mom on back and letting naked baby crawl to
the breast and latch as in the Righard movie.
My goal is to prevent major weight loss, jaundice from lack of
breastfeeding, and to avoid artificial feeding if possible.
Many babies will latch by day 3. Those who do not are sent home pumping
and by day 3 bottle feeding with instructions on how to bottle feed in a
way that will not interfere with normal suckling at the breast.
Most of these babies will latch in the end.
What always amazes me is that I see just as many babies who are born in
natural births without medications who do not latch in the first days.
Israeli moms can have up to 20 ultrasounds during the pregnancy, just to
see the baby. According to Beverly Beech in her booklet " Ultrasound
unsound", this could also be a contributing factor to non-latching.
Esther Grunis, IBCLC
Lis Maternity Hospital
Tel Aviv, Israel
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