I have a most frustrating case, and permission from mom to post.
Baby was born on January 3 (Wednesday), mom's third baby born weighing
10lbs even. Mom nursed first two each for 15 months. Baby was disorganized
until late Thursday, when she latched well and nursed well the next few days.
On Sunday, the baby was still not gaining, so docs ordered supplementation.
Mom protested, as each of her first two took several days to start gaining and
then took off and did just fine, but pediatrician on call overrode her and
ordered supplemental feeds. Mom refused bottles and insisted on a cup
feeding, which was done. From that day on, baby has refused to latch, even
though supplements were only done for 1 day, after which mom had plenty of
milk to pump and cup feed. I think mom was discharged that Monday (the 8th)
with infant weighing 8lbs 14oz.
We first saw her in our clinic when baby was 7 days old (on the 10th). We
recommended lots of skin-to-skin, switched her from cup to finger-feeding,
tried supplemental feeder at breast, but baby wouldn't latch long enough to
get it going, and offering the breast as a pacifier between feeds.
Mom was pumping and offering breast every 2 hours, as she was concerned
about weight gain. If the baby refused the breast, she would finger feed
(about 2oz). I saw her again on the 16th (baby 13 days old) and encouraged
her to start letting the baby set the pace for feeds - I suspected the frequent
feeds were not coming at a time when she was interested in eating. Mom has
changed to about every 3 hour feedings (following baby's cues), but not much
improvement. Baby will latch and nurse a bit about twice a day, which is
encouraging, but only when she's been awake for a bit before the feeding, and
is very alert.
Mom has these other two little ones to keep track of, and her husband is a
busy dairy farmer. Luckily her mom is staying with her and is a big help. She's
pleased to be able to provide the baby with her milk, and will continue
pumping no matter what, but is discouraged this baby won't latch. She
continues frequent skin-to-skin as possible, but is deterred from this by
freqent unscheduled visits from her inlaws next door, who just walk in.
She's giving up on finger-feeding and changing to bottles, because the finger
feeding was taking ages. She has a perception that the baby's suck is "getting
weaker" without the practice at the breast. I observed a finger feed, and
noted a lot of tickling the roof of the baby's mouth to keep feedings going.
Baby is gaining well, over 1oz/day, so I wonder if she's being overfed - not
having any motivation to latch? Baby was back up to 10lbs on Friday the
19th - 2 weeks 2 days - on a different scale, so it's not like her weight gain is
overly rapid, but it has been rapid since day 7 or 8.
Any thoughts or things I might be missing in this case would be much
appreciated.
thanks!!
Kirsten Berggren, PhD, CLC
Lintilhac Breastfeeding Clinic
Williston Vermont
and
www.workandpump.com
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