Hi Sue,
Congrats for having taken the exam and Good Luck!
you write;
>>Is it possible to encourage a 10week baby back onto the breast? He has never
breastfed "properly', lost weight and was hospitalised at about 3weeks, for
a few days. Seemed to latch on, take the let-down of milk but not continue
to feed. Has had bottles of expressed milk for at least 6weeks now and
refuses the breast completely now. Seems to have a bubble palate and doesn't
seem to maintain a strong suck on bottle or finger. <<
Absolutely!!
Assuming Mom has plenty of milk, my preferred course of action  would be to
encourage Mom to try a day (8-12hrs?) just at the breast, no supps at all.
Most likely he will resist at first but as the day wears on and he becomes
more and more hungry and more and more adept from trying (hopefully!), he
will become more willing and capable. Mom will be concerned about his intake
but reassure her that this is really not an issue with a ten wk old and for
this brief period of time. He will not allow himself to starve at this age.
Assuming this helps him to take off at the breast he will obviously need
close f/u, wt. checks by you until consistent gain has been established.
If she is reluctant to try the preferred approach I would consider cup fdng
ie. attempt at the breast for designated period then suppmt via cup. I just
wrote an article for the Medela Messenger (winter edition) where the Mom cup
fed for 6 wks before successfully transitioning to the breast. You can view
at medela.com.
Lynn Shea Rn,Bsn,Ibclc
Franklin,Massachusetts

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