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Subject:
From:
Lynn Shea <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Fri, 3 Aug 2001 08:42:48 EDT
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Dear Sharon and Sue,
Sharon writes;
>>I would=
 be very wary of any strategy involving "forcing" the baby to breastfeed by=
 witholding all other sources of milk.  This baby sounds like he has a real=
 sucking deficit of some kind - you say that he doesn't even suck well on a=
 bottle or a finger and the SNS and shield have both been used with no=
 success.  Witholding the bottle will not cause this baby's problems to=
 suddenly disappear - on the contrary, it may cause the baby so much stress=
 that feeding attempts may even get worse. >>
I was very pleased to read your response to my suggestions as I anticipated
the valid objection and hoped for the oppurtunity to respond!
My impression of Sue's post was slightly different than your own in that I
understood that the baby had quite a bit of trouble nursing in the newborn
period with some attempts at intervention but that the Mom had been bottle
fdng EBM since that time with  occassional (?) atts at the breast. While the
baby may very well have some type of anatomical or iatrogenic sucking
disturbance, supported somewhat by the experience of the sibs and the current
sucking difficulties with the bottle/breast, the chance that it would still
preclude breastfdng., at 10 wks, is relatively rare. "Most likely" , from a
statistics standpt., he had a latch or suckling disturbance early on (much
more common!) that was exacerbated by the bottles. The quickest and the
easiest (long term) way to find that out is to try the previously suggested
time span at the breast only. This does not mean that the Mom should do
battle with the baby! On the contrary I would suggest that she climb into bed
with the baby, offering much skin/skin, perhaps a bath etc. continually
ceasing the oppurtunities to try but stopping when it becomes a battle. Of
course the personalities of Mom and babe are a huge factor here and in the
case of the very hungry, angry babe I might offer some cup fed EBM to calm.
At any rate, if the baby has shown progress by the end of the time some
assumptions might be made regarding the degree/type of suck disturbance.
Having worked in the hospital and in the home, I have seen many babes with
latchon/suckling probs not easily remedied with positioning but seemingly
remedied with time and persistence. Did they have some type of "bigger"
sucking disturbance as described? maybe.....but did it preclude
breastfeeding?.......not often.
Sharons remaining suggestions are all great but involve a lot more time and
effort on the Mom's part when in fact she might be thinking "can he do it or
not?-either way lets move on."
Lynn Shea Rn,Bsn,Ibclc
Franklin,Massachusetts

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