Dear LACTnetters:
I have this mother's permission to post as she is tiring of
breastfeeding/pumping as she has had to for many months...
I'm wondering if any of you would have suggestions for improving an older
infants suck/latch that due to initial difficulties continues to be less than
optimal perhaps due to habit.
baby girl 9 1/2 mos., BF 5-6 x's/day, does best when before nap/sleep,
measured intake about 2 oz per feed; supplemented with EBM & ABM via cup at
this point so gets "enough"; suck has improved in strength and coordination
over the months but not optimal; on solids since 6 mos. and handles them well
(swallowing, chewing WNL) get EBM with solids to increase breastmilk intake.
Brief history: breech, C-sec; seen by me at 8 1/2 wks.; high, arched palate,
weak oral musculature-lips,jaw,tongue-,almost absent gag reflex; seen by OT
&Speech therapists and neonatologist; SNS use sporadically, bottle feeding
recommended by speech therapist when breastfeeding too stressful for mom &
baby; exercises to increase proprioreceptiveness, etc.; milk supply
fluctuates but on low side usually; mom dislikes pumping as she's had to (no
doubt!);has taken Reglan, Domperidone, Syntocinin to increase; seen by or
phone consults with other LC's with advanced practice expertise with suck
difficulties (mainly on her own intiative- though encouraged her to see one
LC but travel distance is an obstacle). This baby has improved her
breastfeeding, wt. gain WNL, other motor development WNL.
She is being seen by new OT for re-evaluation this week; I will be present.
Mom wants to continue to BF for as long as she can into toddlerhood or beyond.
Any suggestions appreciated, your time and effort acknowledged and thanks!
If you need more info (there's lots) please email me privately and I'll
answer your questions.
This mom is a testament to "hanging in there" and can go along with "maybe
this is the best it can be" for a time and then just gets to hoping she can
BF long term and improve things to assure that she will be able to.
Warmly,
Barbara Latterner, BSN,RN,IBCLC
"Nurturing the Nursing Couple"
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