Dear Jennifer,

On Cindy's website, breastfeedingonline.com, there are Jack Newman's handouts 
which include "on latching" and "breast compression," both of which may be 
helpful.  There are now video clips also on latching which show good latch 
technique.  Perhaps, a few days of supplementing at breast would help baby organize 
his suck and get the picture of how to get milk from breast.  I'd suggest she 
let baby nurse, without supplement open, and then as soon as he stops 
consistently swallowing, open up the tubing to get him to regain a rhythm of s/s/b 
(suck/swallow/breathe) and then clamp tubing again, repeating as necessary.  If 
he's tiring, he can finish what's in supplementer rather than have bottle 
feeds.  This keeps him at breast while teaching him that if he persists he'll 
continue to get milk.  A 5 Fr. feeding tube in bottle, ala Dr Newman's homemade 
supplementer, would be least expensive and likely be fine for short interim-days 
to couple of weeks.  If need for supplementing seems to be taking longer, an 
SNS, or Lactaid could be used.

Hope this is helpful.
Barbara Latterner, BSN, RN, IBCLC, RLC





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