Okay, here is the question I have for a patient that my pedi saw yesterday in
the office.
A two day old infant that has never successfully bf at the hospital but was
discharged on ABM.  Mother is very discouraged, told she had flat nipples was
given shells and sent on her way.  The pedi saw the baby yesterday.  Bth Wt.
7' 10", today 7'.
The infant has good rooting reflex and will open fairly wide.  Breasts can be
shaped well enough that infant should be able to latch on if sucking good be
established.  After 15 min of trying to get a latch  and using a little ABM
on the nipple for encouragement.  The most that could be achieved was one
little suck and then the baby would push away.  Mother was told to discontine
all artificial nipples and pacifiers and was sent home with SNS to finger
feed and pump breasts.  Skin to Skin contact was also reccommended and to
watch for rooting and to keep trying to get the baby latched on.  Mother did
say that the attempts to latch on in the Drs office were the most promising
that she had experienced.  Mother is to return to office on monday to check
weight again and further evaluate.  Diaper checks were also explained and
only about 15 cc abm in the sns was recommended every 3 hours, instead of the
full ounce the baby had been receiving with the bottle.  Mother called in
today...infant very distressed and not satified with 15cc of sns.  Only happy
with a finger to suck on constantly.  Still will not latch on to the breast.
 Pedi wants to increase the amount of ABM and even told mom if she has to
give a bottle as a last resort to go ahead.  I should also mention that the
baby is having "gassy" spells that also lead to prolonged crying.  Any
suggestions out there that have not been thought of...I really feel sorry for
this mother.  The hospital that she delivered in does not have any real
Lactation support and she really got off to a bad start.  I really think this
is nipple confusion but thats not comforting when you have a hungry
frustrated infant to contend with over the weekend..  I would love to hear
any suggestions that anyone has since this Pedi is willing to work with this
mom and get her breastfeeding!

labor3