I have a mom I have been working with for a month.  This is third child
and all have had trouble getting latched in the very beginning-small
mouths, large nipples on mom, but by a week or so the two brothers were
feeding at breast.  This baby has fought the breast from the beginning.
I did a consult on day three and Sarah would intermittently latch on and
maybe take two sucks and then pull away and cry.  At that point we
figured it would just take her a little time to get used to the breast.
Mom has gone back to work with the other children and has used the
Nurture III pump, so she started pumping and she and dad took turns
finger feeding Sarah.  The breast was always offered and mom tried
different ways to get Sarah interested in latching on and nursing.  All
to no avail and now feedings were being done by bottle also.  Baby has a
good suck and can suck the milk out of the syringe and tube with barely
any help.  With Thanksgiving and Christmas holiday season in the US, mom
is getting discouraged having to spend so much time feeding this baby.
She has done skin to skin and lots of holding and cuddling.  Last weekend
she tried the warm bath "rebirthing" and Sarah latched on and actually
nursed.  Mom discontinued other feeds and Sarah was on breast only for 3
days or so.  But she was making mom sore, and it got so painful that mom
couldn't handle breastfeeding, so she went back to syringe and bottle
feeding for a couple days.  Mom's nipples are coming out of Sarah's mouth
kind of stretched outward toward the arm, and she had sort of a small
blood blister right below the nipple.  I saw mom today and nipples are
still pretty tender, but the blood blisters have been reabsorbed.  Sarah
is again fighting the breast, taking a suck or two, crying, trying to
push away.  Mom has gobs of milk, she even compresses the breast to
squirt milk into Sarah's mouth.  But it doesn't make Sarah suck.  What
can she do?  She feels that she is spending so much time with feeding
Sarah, that she is taking away from her other two children.  She is a
really neat mom, but she needs to see a light at the end of the tunnel.
She did say she would try the warm bath again.  What other suggestions do
you have for her to try.  What have I missed?

Pat Bucknell, IBCLC
Avon Lake, Ohio (where it may be Jan. 2, but today was 50 degrees!!)