I'm working with a mom that was referred because baby wasn't back to birth
weight at two weeks.  Mom has extremely large nipples.  We worked on better
latch and keeping baby in close but transfer is never more than 4-6cc.  We did
breast compressions, switch nursing and still can't get much transfer.  Mom's
supply is good she's able to pump 2-2 1/2 ounce from one breast while nursing
baby at other breast.  This has been the routine that we have done for past
week to fatten baby up with expressed breast milk via finger feeding. (We
tried tube at breast and mom was too frustrated getting large nipple and tube
in baby's mouth.)  I was hopeful that when we got some weight on baby she
would be able to do a better job at breast.  Today's follow up has baby up 8
oz., but still only transferring 4-6cc.  Mom decided to go to bottles and
continue to pump even if she has to pump for a year.  Dad said he even has
trouble getting anything more than nipple in his mouth  and doesn't see how
they will ever get more in baby's mouth.  He said this after I had offered
suggestion that mom should continue to bring baby to breast as her mouth will
grow and she maybe able to do better job in the future.  Any suggestions or
help would be appreciated.

Warmly,
Pat Lindsey, IBCLC
Pediatrics Plus, Orlando, FL