Hi everyone,
I could use your ideas. I will be seeing this mom in just 3 days.
Baby is 8.5 months old and stopped nursing almost one month ago. Mom dearly
wants to do whatever she can to turn this around.
Background: This baby had early latch problems - a suspected tongue tie -
that mom perceived resolved itself. (I did not know them then.) I suspect
the baby continued to suck poorly without the mom knowing it, and milk
supply degraded over a long period of time until it wasn't enough to
satisfy him. Mom introduced solid foods and it sounds like he came to
depend on them for nourishment. Around 7.5 months, following a hearty
evening meal, baby refused to nurse. That same night that the parents
happened to initiate "sleep training" their baby. (In the US this term is
used for various strategies to get a baby to sleep for a longer chunk of
time overnight than they would voluntarily do.) After that night, the baby
never again nursed. The mother began pumping and feeding him her milk via
bottle, which he accepts. Initially she did not have enough milk, but after
pumping lots, she now makes enough. Mom spoke with the clinical staff of a
local ENT office and feels assured that baby is not refusing the breast
because of an anatomical obstruction or respiratory issue. This mom is
flexible and is willing to try lots of things (she has already reversed the
sleep training) if it will get him to nurse.
Lots of clear reasons here why this might have occurred - but now what to
do about it? The baby is extremely unwilling to be coaxed back to the
breast - he turns away, or bites, or plays with the breast with his hands
instead. She has tried MANY things, although not yet co-bathing or nursing
when baby is actually asleep.
My plan so far is to enter the room while baby is sleeping, wait for REM
sleep, latch the lightly sleeping baby on - probably to a nipple shield so
it resembles the bottle he is comfortable with (but perhaps to the bare
breast?) - and immediately start supplementing at breast via tube or curved
tip syringe, so that once he notices he's breastfeeding he stays for the
milk. If that works it will be easy to incorporate more and more
sleep-nursing and progress from there.
But if it doesn't work?
I imagine I could
- have them end bottlefeeding, so that any sucking an 8-month-old might
still want to do requires him to go back to breast
- or make bottlefeeding increasingly difficult (slower flow nipple, etc)
while making flow at the breast fast and appealing
- try unusual positions, or walk baby around while latching
- try a multi-day process - tube in bottle nipple, tube in shield, tube in
shield at breast
- feed baby solids - but not liquids - before nursing attempts, to increase
his thirst, and thus his willingness (is that barbaric?)
- skin to skin babywearing, hanging out and watching other nursing
babies...etc.
Thanks in advance!!
April
--
"There isn't anyone you couldn't love once you've heard their story."
- Mary Lou Kownacki
April Rosenblum, IBCLC
Give them the gift of worry-free breastfeeding!
West Philly Lactation has gift certificates for baby showers.
www.westphillylactation.com
267-888-MILK (-6455)
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