Yael,

I agree with everyone's posts about your baby who will latch but not suck
and add my own experience with a baby doing the same thing 2 days ago.  

Mom had an emergency C-section for fetal distress (cord around the neck).
Mom and baby were both stable postop but for some reason baby stayed in the
nursery for at least 2 hours and had a bottle before bonding with mom.  Mom
says she attempted to nurse the baby in the evening with no luck and baby
was bottle fed in the nursery at night.  Next morning the floor nurse is
gung-ho about getting nursing started and mom agrees.  She puts swaddled
baby up to mom's breast in the cradle hold and baby roots, appears to attach
and just lays there looking at her.  RN brings me in, excited that she has
gotten baby to latch, then leaves.  What's wrong with this picture?  Baby
has never had any skin-to-skin contact with his mom!  

I undressed the baby and placed him vertical skin-to-skin on mom's chest a
la Dr. Smillie.  Baby roots like crazy and attempts to self attach, crawling
effortlessly down to mom's nipple.  Mom has flat nipples and baby is doing
some kind of weird tongue movements.  I think tongue-tie but he can extend
and lift his tongue well.  Every now and then he deviates his tongue out the
side of his mouth like he's trying to lick off some ice cream.  He sometimes
sucks his tongue and grooves it but the edges are thick and weird looking
for lack of a better technical term.  This kid is alert, strong as a bull,
and really seeking to latch.  Every time he gets his mouth around the breast
he goes immediately to sleep.  Luckily mom can effortlessly express
colostrum into his open mouth so I'm not worried about baby's intake at this
point.  She worked on getting the right positioning and latch on technique
for a deep asymmetric latch, and watched the Follow Me Mum video several
times.  

When he would go to sleep, mom would pick him up and start his instinctive
behaviors going again with positional stability and allowing him to attempt
to self-attach, minimally and gently assisting with the latch.  By the end
of the day, this baby finally latched on and started nursing like a champ.
I really did not think he was going to do it that soon.  His tongue
movements were so uncoordinated at the beginning of the day even though all
of his other reflexes were great.  All he needed was a little unpressured
time to regroup after all that separation and he finally did it.  Everyone
was happy, most of all me at the very end of my day, armed with a nipple
shield and spoons in my pocket that I didn't have to use.  

I still cringe every time I use a nipple shield (a cheater, as I call it)
but with this baby I thought that if we just got something firm enough in
his mouth he would start to suck and then we could take it off and put him
directly on the breast again.  It's my last resort but it works.  I would
have had this mom hand express onto a plastic spoon and spoon feed colostrum
while they were both willing and taught her some suck training exercises
before I left for the day, but no need.  I believe very strongly in not
putting anything into a baby's mouth except the mother's breast unless
absolutely necessary.  

My point here is, try the simple things first (skin-to-skin vertical between
mom's breasts).  They are sometimes the most effective and are free and
non-invasive.  If you are unable to help her, can she go back for a visit
with the hospital IBCLC for an evaluation?  Or are there any more
experienced lay resources available to her?  Is she expressing to protect
her milk supply while working on the problem?  Good luck to you and your
mom.

Linda Anderegg, RNC, IBCLC, RLC in Chicago     


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