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Subject:
From:
"Catherine Watson Genna, IBCLC" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 13 Sep 2005 19:08:31 -0400
Content-Type:
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Offering the breast "for dessert" helps. The baby gets most of his 
bottle, then is encouraged to latch onto the breast for dessert.
Using the baby's built in reflexes for self attachment can work, I've 
had success with having mom distract baby with toys and funny sounds, 
and as part of the "play" place her nipple on his philtrum (that ridge 
between nose and upper lip). Very often the baby will open wide and 
latch. This has worked with babies up to about 4 months old. She can 
also spend lots of skin to skin time, with baby close to her breast when 
drowsy, some babies will latch then.
Bottle bait and switch is another trick. Mom bottle feeds baby close to 
the breast wearing a nipple shield, she slips the bottle away and slips 
the nipple close to his mouth. Often babies will latch this way.

I rarely have to recommend the "tough love" breastfeeding lesson (mom 
feeds baby by cup or spoon only, keeps baby skin to skin on her chest in 
between. Baby self attaches. May cry and complain, but keeps self 
attaching until he or she actually starts sucking. Sometimes that's the 
only thing that works. I stay with the mom, encourage her to speak 
soothingly to the baby, stroke the baby, and we talk quietly. When baby 
gets too upset, we give a little milk by spoon or cup, and then put the 
baby back on mom's chest. I've used this 3 or 4 times, and it takes a 
good hour or two. Once the baby breastfeeds, the mom just offers the 
breast for the next few weeks until breastfeeding behaviour is 
re-established. I ONLY do this when mom has a full or nearly full milk 
supply, and baby has nothing that prevents them from breastfeeding, 
other than inexperience. One baby was a relactation case (mom had HELLLP 
and was in intensive care after birth), another was a baby who had 
required a frenotomy and was bottle and fingerfed for the first month or 
two and though her suck had normalized, she wasn't doing this breast 
thing. Both never looked back once they started breastfeeding. For the 
other kids, it was a longer, harder road.
Catherine Watson Genna, IBCLC  NYC

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