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Subject:
From:
Ann Marie <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 27 Feb 2002 14:02:51 -0800
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Your advice welcome!

28 yo mom G1P1
baby daughter born 2/12/02 in hospital via primary c/s for FTP
BW 6 pounds 14 ounces; rec'd supps of Enfamil (for unknown reasons) via
bottle and cup while in hospital

Home at two days. Home visit at 4 days. Left nipple cracked, creased,
bleeding profusely w/ pumping (Avent pump).  Baby latched well and fed on R.
Parents have been po-ing baby with EBM prn.
Plan: have mom pump L breast and BF off R side until healing occurs.

Home visit at 8 days of age.  Mom has started on Prozac 10 mg/day X 1 week,
then will increase to 25mg/day.  Baby 3 oz under birthweight. Mom reports R
nipple developed same cracks, bleeding as L,  the day after last home visit,
so stopped BF and pumped, feeding baby EBM via Avent bottle using nipple #1.
Mom offers breast often but reports baby latches briefly to breast then
pulls off within three - four sucks.  Agitated @ breast.
Nipple shield introduced w/ excellent success during HV.  "Success" lasted
+/- 30 hours, then baby refusing breast.  Seems to be waiting for milk to
flow out w/o effort on her part.  Mom at this point has chosen to pump and
bottle feed for the foreseeable future, but would love to get baby back to
breastfeeding.  SNS concept has been introduced, but mom not ready to try
it.

So, your ideas? Many thanks, in advance.
Ann Marie Henninger, RN, BSN, sitting for IBCLC exam July 2002

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