I could really use some input on this case. I started working with a mom 7
weeks postpartum because her milk supply had dropped and baby was coming off
the breast and not nursing as long.  I at first suspected Stage 2 OMER after
talking with the mom, but after seeing the baby nurse it appears to be more
a sucking problem that wasn't picked up.  Baby was makeing clicking sounds,
and when I commented on it Mom said that baby had been clicking in the
hospital.  One of the nurses heard it and said "I don't know why she's
making that clicking noise, but at least she's latched, maybe that's just
her nursing style."  So mom left the hospital thinkging that clicking was
normal. Baby  made the same noise with a pacifier and with the bottle.  She
has gained 2 lbs so mom thought everything was fine until she suddenly
stopped getting as much milk when whe pumped.
     When I saw the baby her tongue kept going to the roof of her mouth.  It
was hard to get it to come down and out.  She gagged with my finger only a
little way into her mouth.  Even gagged wtih the Avent bottle that mom had
been using incorrectly(not putting it in her mouth all the way). I started
her pumping and on both Fenugreek and Blessed Thistle (a  milk enhancement
kit by Garden of Grace Herbs). Taught her to do suck training and the
walking down the tongue exercise.  Baby was still going to the breast, but
wouldn't stay long, so I tried a mini-SNS which works fine for awhile. Three
days later with parents regularly working on getting baby to open her mouth
and on suck training things really aren't much better.  MOms milk supply
doesn't seem to be increasing except "slightly" and feedings with the
supplementer are taking 1 1/2 hours just to get her to take 2 ozs.  The baby
usually nurses well in the morning side lying in bed, and also nursed well
in the bath tub.  But mom can't do every feeding in bed or in the tub. and
she is getting frustrated, as most feedings are difficult.  I tried a
Haberman feeder with her yesterday and the baby sucked well on the middle
notch, but not on the short one - she started gagging and crying.
 Any ideas on where to go from here?  I have never had a case this bad
before.  How long should I expect it to take the baby to learn how to suck,
and what else can I do to increase moms milk supply???. Any suggestions
would be greatly appreciated.  THanks.
Peg Merrill, B.S.,IBCLC, LLLL(retired), CCE. Doula, etc...,

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