Dear all:

Well, I would have assumed exactly has had Daillyn that the smaller tube
would increase the baby's ability to draw milk from the breast.
Nevertheless, I just did a case where I worked with a mom whose now 72 day
old premie was taking terribly long to finish feeds with the SNS.  I
assumed that this baby had a reasonable suck since she was past due date &
the digital exam wasn't bad, but lo and behold took absolutely nothing from
breast when I used the small tube.  She barely swallowed - a total intake
of 0.3 oz after a good solid 15 min.  So, I tried the medium tube - and
surprise surprise, the baby took 0.3 oz FROM THE BREAST and 1.6 oz from the
tube.  She swallowed rhythmically.  It was a total pain in the patootie to
do as many test weighings as I did at this visit BUT it gave me the
valuable information I needed about what was best for this mom and baby.
So, I'd say, do periodic weight checks with the various tube sizes as the
baby progresses and reevaluate what's going on with intake from the breast.

Also, I didn't have a chance to go to the conference by Linda Pohl, but my
colleagues reported back to me that she explained the engineering of why
the baby will not take anything from the breast when the flow from the
breast is good. Linda - feel free to pipe in and correct me if I got this
bit wrong. I would say this situation smacks of acquired low supply and mom
will probably need to do far more pumping to get the supply back up and
possibly domperidone as well.

Good luck.  Nothing like this cases to make you work on your counseling
skills.  The constant encouragement is so necessary to help these cases.

best, Susan Burger
Best regards, Susan Burger,

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html