Dear Friends:
     I had the most amazing thing happen in a consult last night for a 16-day
old baby girl and her mother. The baby was born after 38-hours of spontaneous
labor (morphine, stadol, then an epidural and pitocin) and cesarean section.
Hospital cultured b-strep out of the amniotic fluid; the mother was treated
with antibiotics. The baby was fine.
     The mom was taught to "ram the baby on" the breast in her prenatal
breastfeeding class. The LCs and nurses during her 5 day hospital course all
did it. Once she was discharged, she spent the next 11 days ramming the baby
onto the breast, waking the baby every 2 hours ("they said I had to do that")
to feed, and fighting with her baby at breast. She also developed damaged
nipples because the baby wasn't opening her mouth enough.
     Amazingly, the baby is thriving and will still breastfeed, although the
mother is in toe-curling pain. Thank goodness for a good milk supply that
makes for two chins in a sweet baby.
     At the beginning of the visit, we talked about cue-based feeding, and
how working with the baby at breast could be very pleasant as a result. The
baby woke during our chat, and the mother showed me what she had been doing.
     The baby fell into the hole between the Boppy pillow and her mothers' abd
omen. The mother's nipples point down; she had been crinkling her breast up
to the baby's mouth, and had a finger over the lower areola. The baby was
furious; red and screaming and refusing to latch. Mother tried several
positions: cradle, cross-cradle, and side-lying. Fortunately, her incision
has healed and she was comfortable moving around.
     We stopped trying to breastfeed. The mother took the baby's little
jumpsuit off, so the baby was wearing only a onesie (with bare arms and legs)
and a diaper. The mother was naked from the waist up. I suggested she lie on
her back (with a pillow under her knees for support) and put the baby
mid-line on her chest. We were in her bedroom, and the mother was lying on
her bed with lots of pillows keeping her comfortable.
     Now for the amazing part. The baby started salivating and trying to
catch the right nipple and bring it to her mouth, just as in Anne Marie
Widstrom's 'Baby's Choice' video! At the same time, the baby started crying
in a fury and also talking about the breast. (You know that universal
'unh-unh' sound). Over the next 1/2 hour, the baby moved herself from
midline, to the right breast, then flipped herself around and went for the
left breast. Again, just as in the video.
     The baby went through spells of total red rage, screaming and swearing.
Then she would calm, and go to the next step in the process described by
Widstrom. Eventually, she latched on the the left nipple and nursed. She
latched and unlatched herself at least 8 times on that side. As the breast
became softer, the latch became more comfortable until the mother was
completely relaxed.
     Finally the baby slept, pillowed on the breast. During this whole time,
the mother (who had been conditioned to push her breast into her baby's mouth
by all her teachers and hospital staff who modeled this behavior) lay on her
back, with her arms cradling the baby's sides. The baby did it all.
     The baby woke again, and started screaming. She had everything in
position to latch again on the left side, but wouldn't do it. Lots of head
bobbing and dragging her mouth over the nipple and areola. I intervened then,
and shifted the baby so she was aiming towards the right breast because I was
concerned about the mother's tolerance for all her baby's screaming.
     The baby fussed a little, then crawled over to the right nipple and
latched on again and nursed. Just like the Mandy and Mat video, without the
bath! The baby was fine, unless I used my fingers to try and see what the
latch looked like. Then she became furious again, and would detach, then
reattach.
     When I left them, the baby was asleep on the right areola. This whole
visit took nearly 3 hours. I was telling the mother the whole time how
wonderful and patient and loving she was being. I am ashamed to know that
there were IBCLE-certified LCs working with this mother in the hospital.
       My impression, from a craniosacral perspective is that this baby was
going through the instinctive, reflexive process of self-attachment while
simultaneously expressing her memories and feelings at being abused at the
breast for so long. The baby was having a somato-emotional release about
wanting to go to breast but being constantly frustrated about breastfeeding.
     The mother was able to laugh by the end of the visit when she thought of
having to take her clothes off and lie down in the supermarket to nurse her
baby! How could she do that discreetly? Of course she won't. But now she
knows (baby showed her at least 10 times) that she doesn't have to make
breastfeeding happen, that her baby wants to be involved.The level of tension
and worry in this mother dropped dramatically during this process.
     I believe that nursing will go better for them now. We'll have to see. I
will be calling everyday. Elements of the care plan include: no more waking
baby on a schedule, cue-based feeds, let baby say how many breasts per feed,
pumping a little before a feed to soften the breast, and letting baby latch
once the mother is in a good position. No more ramming!
     I'll keep you all posted.
     Warmly,
Nikki Lee RN, MSN, Mother of 2, IBCLC, CIMI, CCE, craniosacral therapy
Adjunct faculty, Union Institute and University, Maternal and Child Health:
Lactation Consulting
Supporting the WHO Code and the Mother Friendly Childbirth Initiative

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html