I have long believed that a baby who cannot feed well is not a normal, well
baby. After all, if a baby weren't able to breathe would the medical
professional seeing him fix the problem by putting him on a respirator and
considering the problem solved? If the baby couldn't wee or poo properly,
would (s)he press on his tummy until something came out and then consider him
OK? I think not. Presumably (s)he would want to know why, and figure out
how to correct it. So why do people simply assume that giving a child a
bottle will fix a feeding problem? "Looking fine" doesn't necessarily mean
fine, and a health care professional should know that. People who have
undiagnosed cancer can look fine, too, you know. People who have strokes or
heart attacks often look OK a few minutes before they collapse. If a patient
is showing symptoms of being unwell, they deserve to be investigated.
Even bottle feeding that is done correctly and with gentle concern can be
invasive and overwhelming for a child who has subtle neurological, muscular,
or sensory integration issues. This baby's behavior indicates that he is
unhappy, unable to organize himself, uncomfortable, or even in pain. If the
routine, simpler fixes haven't helped this baby, then it's time to look
deeper. A thorough and complete lactation history might reveal some clues.
For example, questions that should be asked that give information about the
birth, history of allergies, antenatal complications, more details about the
delays the older child is experiencing, family history of developmental
delays, genetic issues, etc. There are literally hundreds of things that
come to my mind.
And there are many specialists that might be appropriate--here's a few, in no
particular order: osteopath, ENT, speech pathologist, occupational
therapist, chiropractor, developmental pediatrician, infant/child
psychiatrist or psychologist, neonatologist, registered dietician, IBCLC,
geneticist, pediatrician, gastroenterologist, educational specialist (or
someone skilled in early diagnosis of disorders such as autism). Maybe he
needs more than one of these people to evaluate him. Maybe he doesn't need
any of them. But until someone recognizes the importance of this baby being
unable to eat, and therefore, survive, and evaluates him, this Mom and babe
will continue to struggle.
It infuriates me when some health care professionals see babies with feeding
problems, and say, "Well, let's wait a few months and see if he outgrows it.
In the meantime, better just bottle feed. That way, he'll put on weight." If
this kid couldn't breathe, would we be willing to wait a few months to see if
he outgrew it?
Off my soapbox for now, but I'd be happy to get back on!
Barbara Ash, IBCLC
Canberra, Australia
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