Hello all,
Have been trying to manage this on my own but it's getting away from me, so
I'm asking for help from the collection of great minds out there. This last
week has been extremely busy in our little OB dept. Most of our mothers
breastfeed, and we've had several primips deliver babies who, for one
reason or another, got off to a poor start with nursing. The nurses have
been so busy they haven't been able to give the conscientious assistance to
primes that they usually give, and much to my dismay, they didn't call me
about the problems until moms were ready to go home--with babies that
weren't nursing. So, now I've got 3 (maybe 4, I'll find out tonight if the
last one is finally nursing) babies who are having problems with
breastfeeding. 2 are sleepy babies, slow to nurse and hard to keep going
once at the breast. The other 2 are bigger problems, both prefer to suck
their tongues rather than suckle the breast. Baby 1 is 8 days old, mom is
an experienced nurser (2 other babes), very patient, but getting frustrated
with a baby that won't nurse. Cup feeding was even difficult so mom is
pumping and bottle feeding. On day 2 I taught mom how to coax the baby to
stick out his tongue ( by sticking her tongue out to him) and it worked
beautifully, after just a few minutes she was able to get him latched on
and he had his first good feeding since birth. She was able to duplicate
this 2 more times and we thought the problem was resolved, but the first
night home they ran into problems and all success went right down the tube.
At this stage it appears baby has rejected the breast, when brought near he
cries forcefully and fights being put to the breast. Mom has stopped TRYING
to get baby to nurse and is allowing unpressured time near the breast,
bathing with the baby. Had avoided pacifiers and bottles in first 3 days,
used finger to soothe baby when too agitated and to encourage correct use
of tongue. I'm worried this baby will never go back to the breast, and this
mom really wants to nurse for at least 8 months before she goes back to
work. I was present at delivery, it was tough with long pushing and vacuum
assist. Possibility of trauma is likely and I told mom about what little I
know of Cranial Sacral tx(which is very little). Can't believe it but we
have a Physical Therapist at our hosp who DOES it, though not aware of it's
use with breastfeeding problems. He has agreed to talk to the mom about it
and they may try some txs. Don't know what else to suggest with this mom,
any thoughts out there?
Baby 2 is also a tongue sucker who didn't nurse nutritively for 2 days
before the nurses picked up on it, by then mom's breasts had had so little
stimulation they wouldn't produce anything with the feeble sucks this baby
would do when correctly attached. So now this mom is pumping and cup
feeding a rather jaundiced baby (by the way, baby 1 was jaundiced too, to
the point of needing bili wrap). This one is enjoying the cup so much she
doesn't want to go back to the breast, mom thinks she is now sucking her
tongue when at the breast and doesn't feel any drawing when baby nurses.
Will be seeing her tomorrow, in the meantime I've instructed her in the
same interventions as the mom in first case (with exception of Cranial
Sacral tx) and additionally to avoid pacifier or bottle until baby suckling
at breast. I feel like I'm missing something, but don't know what. I've
never had this many moms with problems at one time. I'm also L&D nurse and
am worried I won't be free to give as much attention tomorrow as some of
these moms may need. I do go in on non-work hours to help moms with
problems, just wish they had let me know before so many escalated at once.
Sorry this is so long, but appreciate any help any one who got through this
diatribe is willing to give.
Warm thanks,
Mary A. Banaszewski RN, Lactation Specialist
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