I had a similar situation in this past week with a premature infant, now 36 weeks corrected age, whose mother had a very forceful MER--plus I think she had an oversupply problem.  Baby is 2 1/2 weeks old & about 3 days into taking the breast well developed similar symptoms:  panicky look, letting go of the breast & he would have a mouthful of milk. He was attached to monitors as well and would have a drop in his oxygen saturation levels & would recover within 20 seconds once he came off of the breast. I had her pump until the first initial let-down was passed & she pumped over 300 cc in less than 5 minutes.  However, after that, babe was able to go to breast & nurse again without any difficulty.  He also gained better because he got more of the hindmilk, I think.  The freezer is filling up with the extra milk but they are doing well.

I think even without oversupply being involved, a forceful MER can be disruptive.  I had to have some swallow studies done on myself this past week & the nurse injected 5 cc of water straight back in my throat accidentally & I choked & gagged & I'll bet I was looking panicky as well!  I also had a large nasogastric tube in at the time--I'm going to dread the next time I have to pass one on a patient of mine.

Identifying strongly with my little patients,

Sincerely,

Linda Madsen, RN, IBCLC

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