In einer eMail vom 18-7-01 17:42:29 West-Europa (zomertijd) schreibt
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> All of us have seen babies who suck their tongues, don't flange right, suck
> on the lower lip, have slightly decreased muscle tone and so on.
I saw a mom and baby with a similar problem today. My extra problem is that
I´m not called in untill the problem has found itself a safe place in the
family (1 weeks pp this time, sometimes even later). By this time the mom is
exhausted, desperite and just doesn´t want to try any new things or buy
another piece of equipment ´cause she´ll probably stop the who+e thing so why
bother trying anuthing else´?
This mom today presented with both nipples cracked and 2 plugged ducts at one
breast, without fever, but the plugs were already starting to become hard an
unmoveable. The problem started right after birth, mom has very firm breast
and hardly a nipple (not inverted, just plain flat), baby with a small mouth
and receiding chin and a short or not protuding tongue (couldn´t quite find
out, baby had low reflex to lipstimulus), baby is a lazy kind of feeder, both
at breast and at bottle. Midwife tried to solve the problem with a nipple
shield and it looked like the baby was nursing. But nothing was actually
coming out. Mom started pumping, breastfeeding and bottlefeeding pumped milk.
When feeding at the breast the bay keeps sliding off the moemnt he tries to
latch. With the shield he kind of grabs the top part of the shield and while
sucking, pushes the nipple into the areola. Yesterday the wellbabyclinic
nurse came for the initial homevisit, saw the problem and called me in. mom
has plenty of milk and pumps 1 bottle a day more than the baby needs, but the
milk flows very slowly.
In this case I advised the mom to stop nursing for one or two days to get the
nipples healed abd to let the pressure of of herself (don´t know how to say
in english excactly what I mean), pump milk and feed the baby, preferably
with a wider bottlenipple than she uses now. Teached her how to work on
deplugging the ducts. We made an appointment to see her again in 2 days to
start relatching the baby when the nipples are healed and the breasttissue
softenen.
This is not what I would <want> to advise, tho, but is is all I could come to
in a compromise where the alternative to the other end was kind of cold
turkey weaning. What I would like to advice is more like :
... Persistence
... is almost all that matters! No, persistence and ABSOLUTE absence of
... bottles.
... Close follow up by a skilled, experienced LC will get moms through these
... first days. Support and encouragement may be just as important as
... adjusting the latch. (Jay Gordon)
~~~~~~~~~~~~~~~~~~~~~~~~~~~
Gonneke van Veldhuizen, IBCLC
MOM, LLLL, primary schoolteacher
Hiilensberg, Germany
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