In the case of my sick baby with a G-tube, I have talked to the mom a couple
of times about breastfeeding when she was pregnant (and at that time the
baby was not expected to live after birth) and after the baby was born and
struggling with feeding issues.  This couple seems has been through the
ringer with this pregnancy and ill baby.  They come from a background of a
couple generations of no breastfeeding in the family.  They don't know
anyone with a breastfed infant (except me!).  The 2 year old sister was not
breastfed.  And now that their baby has been ill, and had surgery, and faces
more surgery (to remove sequestered pulmonary lobe) in the future not one of
the many specialists involved in this infant's care has suggested that the
mom's own milk would be helpful for this baby.  I think it's hard for them
to believe that my nutty belief in breastmilk is valid.  I don't think after
all they've been through that the mom feels like she can undertake
relactation and still have time for her neglected 2 year old, and all the
driving back and forth to specialists, especially since they have no reason
(other than my suggestion) to believe it may be helpful.  The speech
pathologist working with them has responded to the baby's gagging and
refusing oral feeds by using a faster flow nipple, chin support, and firm
pressure on the palate.  Baby responds to this by even more distress, I
think because she doesn't like the fast flow.  Mom is trying out this
weekend some slower flow nipples, lots of carrying, and not trying to push
the baby to feed quickly, but allowing her to take her time (and use the
G-tube for top-offs that will likely be necessary.)  If the baby continues
to reject feeding and suffer with constipation and stomach upset, I'll try
again to get them to consider human milk, radical as that may be!
Jennifer Tieman
Family Physician
Mom to 4, including nursling Caroline Rose born 5/31/03

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