Dear Everyone,
I would love advice or info on this case, please write privately as well as
to the list if possible.
I had a very disturbing consult yesterday for more than one reason.
This is a 23 year old mother, second child, who she had here in Israel.
This is an American girl, living away from all family. The first BF for 10
months, 2 months into the mothers second pregnancy. The baby was born 36
weeks, at 2.300 and was then in the NICU for 4 weeks. I will repeat the
info the mother gave me. At first I thought she was not telling me
something, but after speaking to her I realized that she really had no idea
that anything was out of the ordinary.
They told her that her baby was not swallowing well, which can happen with
premies. It was fed by tube for about 2 1/2 weeks, and then by bottle.
The baby never took her milk by bottle. That was the whole reason she
called me, total frustration. She has been pumping, her freezer is
stocked, and the baby has gotten none of her milk. The baby is getting
Neosure boiled up and thickened with 3-4 tablespoons of cornflour. The
baby does not have reflux. If the milk is not thickened, he either spits
it up or it dribbles out of his mouth. They told her that his swallowing
muscles are immature, and he needs something thicker. They said there is
no way to thicken her milk. She tried herself, and it never really got
thick, just dripped out of the baby's mouth. They have told her this is
totally normal, nothing to be concerned about, and it might take a month
before the baby can get her milk. They sent her to work a bit with a
therapist for the swallowing, who the mother said "didn't really tell us
anything."
I read the discharge, and I can't say I understood everything because all
was written in Hebrew, and in doctor's handwriting, but these are some of
the bits that I gleamed.
Delayed neurodevelopment, lack of swallowing and low tone, No Moro reflex,
agpar was 9 after birth, and then again, all tests came out normal. By end
of stay, baby cried for feeds, tone improved, suck improved.
Discharge and monthly checkups.
My questions are as follows:
First, isn't there a way to thicken mother's milk? Why in the world can
this baby not take it by bottle?
What can possibly have be going on with baby ? How could they make this
mother think this is the most normal thing in the world? Am I missing
something here? I know there is not a lot of information here, but can
anyone shed any light?
The mother is going to America (Lakewood, NJ) and I strongly suggested she
get a second opinion. Can anyone recommend anyone in the area? This is 1
hour from Brooklyn, so it could be that direction also.
Thanks in Advance,
Jessica Billowitz, IBCLC
Israel
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