Friends at Lactnet,

        As introduction, I am Leslie Payne and I have been a LLL Leader for
17 years.  My specific need at this time is help with a baby whose birth I
attended 6 weeks ago as labor assistant.  The basics are this:  Laney was
born in a state of secondary apnea and, thus, was in the special care
nursery for 2 weeks until she came home.  No one can say at this point
whether there is any neurological damage or problem, but feeding her has
been a serious problem.  She came home on an NG tube which was removed at 4
weeks when the parents proved that they could get enough milk in her by
bottle.  Her activity at the breast is disoriented at best.  She is on
phenobarbitol to prevent seizures.  (She did have 2 seizures within 24 hours
of birth, none since then.)  The neurologist considers this necessary for at
least another 6 weeks.  I believe this has some effect on her feeding but it
is not negotiable at this point.  Her feeding habits and abilities are
frenetic and not very predictable.  She does better with the bottle than the
breast because the mom can basically jam the bottle nipple in her mouth and
squeeze the milk out if she has to and she does sometimes have to do that.
This same method has been unsuccessful at the breast! The basic problem at
the breast is that she will not latch on AND suck.  Sometimes she latches on
but won't suck, mostly she either falls asleep or screams.  I know this
sounds like run-of-the-mill nipple confusion but since it is imperative that
Laney get enough milk (she's on the thin side), the parents are nervous
about taking her off the bottle totally.  Also, it took her about 2 weeks to
learn to bottle feed well enough to get rid of the NG tube and they don't
want that back.  Our newest plan is to pick the most-likely-to-be-successful
feeding of the day (or night) and try to breastfeed only that one feeding
until time for the next feeding, then bottle feed the rest of the day.  This
way we cut out at least one feeding where Laney has possibly learned to hold
out for the bottle.  She does almost no non-nutritive sucking and never has,
really.

        If you think you can help us, PLEASE do!!!!!!  This mom is dedicated
to pumping and bottlefeeding for at least a year and has more motivation to
do so than other  moms I've worked with.  But, I've never seen that work for
a whole year before.  Of course, I would lots rather see her nurse her baby
at the breast for all the reasons you all know.  This is her first baby, so
she doesn't know them all but really does have the desire.  She is very
scared about compromising Laney's progress, though.

        Please, either post to me personally at [log in to unmask] or post
to the list with Laney's name in the subject so I can find it quickly.  I do
believe we are at the end of our chance to get this baby to the breast and I
regret not working harder earlier, but there were lots of extenuating
circumstances.  Thanks a lot.