Hello Wise Ones,
 
A mom I've been working with has been expressing with a rental-level  
Ameda,  but has found out that her insurance company will pay for an Hygeia  Q. 
The baby was "only" 2 weeks early, and was frank breech, but her entire  
system "looks" like a baby born much earlier. Even past due date, her ability to 
 feed was still severely compromised. Even after frenotomy ( which I 
agonized  over making a recommendation since it was SO far back, and baby so 
"affected"  somehow) baby only went from moving 0.2 oz to 0.4 oz at the one 
feeding I  observed.  Many bottlefeeds take 45-60 minutes. ( Faster flows cause  
more leaking, gagging, and shutdown) Mom confirmed her behavior is  similar 
throughout the daily cycle. Even on the bottle, as of a week ago when I  saw 
them at their first CST session ( watched a new CST practitioner for an 
hour  since the amazing one I worked with for seven years moved away....), her 
SSB was  "broken", milk transfer slow and choppy, and she still gets into 
crying jags or  shuts down when undereating or overwhelmed. ( Not that I blame 
her.) Even after  the frenotomy the tongue movement is limited as her 
posterior neck and  shoulder region remains so tight she can barely open her 
mouth and latches  shallowly with a shield and not at all without. SO, my 
question is: for a baby  whose mom is still so reliant on the machine to express 
milk, will the Q work as  well as the rental by Ameda? Mom is about to travel 
with baby to Europe and  we've already discussed how the Q is lighter than 
the Endeare because it has no  internal battery, and how that might play 
out. But here, Hygeia is still a  fairly new kid on the block, so if anyone has 
experience with it, we'd be most  grateful. I am going to talk to the mom 
later today, to get more updated  information since there has been a second 
CST session, but I'm not sure things  will be that much different. We've 
worked very hard on this, but mom is still  likely to define "breastfeeding much 
better" as  baby remaining awake and  trying longer without actually 
transferring much milk, so we are walking a very  fine line here. She asks "how 
can I make my baby more dependent on my breast"  and I know what she means, 
but I'm trying to reframe her expectations, and just  keep her baby well fed 
and growing and especially developing normal tone, range  of motion,  and 
state control as well, before "making" this adorable  little baby do anything 
other than what she's doing...
 
Thoughts?
Peace,
Judy, PS the CST is an OT with Early Intervention expertise,  which I'm 
very glad about as well... 

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