I have a question to do with the baby of an aquaintance of mine. I have
permission from her to share the details I know of her situation:
This woman had a breast reduction some years ago, and has been
subscribed to the "Breastfeeding After Reduction" mailing list (BFAR)
for quite some time. This is her first child. He was born on the 20th
of Jan, at 7 lbs 6 oz. This was a homebirth, no epidural or anything.
I'm not sure about the rest of the labour (how it went) as we haven't
been talking "birth stories" yet. Just BF horror stories. ;-)
On the 23rd (72 hours) he weighed 6 lbs 10 oz.
24th: 6 lbs 14 oz
25th 6 lbs 13 oz.
I gather that yesterday he gained 1/2 an ounce, and the midwife was not
very pleased with this.
The lady is pumping her milk with a Medela Pump-in-Style (PIS) and
getting about 1 ounce from both breasts put together (1/2 oz each side)
per session. So she gets about 8 oz. per day.
The baby nursed really well with great gusto to begin with, but when it
was discovered at 72 hours how much he'd lost, there was a great panic
to get him to gain, and she started trying to use the lact-aid system
with a lot less success. He seemed to latch a lot less well with the
lact-aid, and obviously wasn't efficiant at getting the 1/2 oz out per
side, and she hadn't been putting him to the breast as often as she
should have (and waking him for feeds). Hindsight is, of course, 20/20,
and she kicks herself, but now she's got to live with the consequences.
He also got quite dehydrated in between and that was another worry to
deal with. All this is surely not helping the already-low milk supply.
anyhow...as latching was not going great, she started finger feeding
with the lact-aid, and he now much prefers this method of feeding. He
has had one (Avent) bottle so far, about 2-3 days ago which didn't go
any better: he promptly vomited everything back up, seemingly because
the flow was too fast and caused gas (she thinks). She was successful
at getting him to latch at a lactation clinic on thursday, but doesn't
have another appointment until tuesday next, and can't seem to get him
to latch WITH the lact-aid by herself. She also has a hard time getting
him to take in enough with the lact-aid by fingerfeeding (very slow
flow) but he hated the faster flow of the bottle. I gather that the
midwife, who she says is very pro-bf, but concerned about the baby, does
not want him comfort nursing for now...which would of course stimulate
the breasts more, even if it were after he'd been well fed at a finger
feeding, but the thought is that he'll spend too much energy comfort
nursing (given that her breasts already won't be producing so much as
someone who hasn't had a reduction) and gain even less then, and he'll
only learn to suckle the "comfort suckle" rather than a "feeding
suckle", which would eventually be "bad" for him. I'm not sure how
valid this worry is...it may be very valid, in which case fine, but I'm
not knowledgeable enough to figure that out yet!
This lady would really like to get him to gain his weight back quickly
and be able to re-teach him how to nurse, but seems to be having
difficulty with getting enough food into him for that to happen.
Does anyone have any wise ideas for this mom and baby, for them to gain
weight and get the finger-feeding behind them? It is a long tedious
feed, I gather, that takes a lot of effort...and on top of that, the
father seems best at it, and he returns to work in a week's time and the
mother is already dreading spending a day trying to finger-feed AND pump
and everything, if she can't get him to nurse with his lact-aid.
She has a SNS system as well, and says she'll try this one with a
slightly thicker tube and see if that goes okay, for the finger feeding,
but doesn't have much more to try except that...and even if it goes okay
for the finger-feeding, it wouldn't be as easy to latch with probably.
Thanks in advance if there's any wise suggestions out there, we'd be
greatly appreciative!
Fio.
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