In a message dated 4/9/0 4:42:30 PM, [log in to unmask] writes:
<< I’d like to ask some advice and opinions in this case:>>
Yael,
Chris responded with suggestions of winning, rather than forcing this baby to
the breast, as well as use of massage. I have some additional comments along
those lines.
<<Mother of 6 week old baby, fifth child (all under 7 years old), did not bf
first three, bf fourth for 18 months and fell in love with bf. Is referred to
me with baby refusing breast most of the time, and milk supply dwindled.
First 4 weeks bf exclusively, was told by nurse “no problem” even tho baby
stooled every 3 or 4 days; did not re gain birth weight until 4 weeks. >>
Have you explored the reasons for this? You might imagine the busy household
played a role, but it was busy with #4 too, so I would suspect another
problem. Was she nursing this newborn like a toddler (which can mean poor
positioning and latch)? Do you have idea of what his suck and feeding
patterns were early on?
<<When I saw her, we got baby latched on for brief minute, then pulled off
and fussed. Tried using lactation aid to get baby to stay on, stayed on a
couple minutes longer but still pulled off and fussed. The only thing that
got this baby to calm and stay latched on for more than about one minute was
when the mother stood up holding baby, rocking him fairly vigorously while
standing up, and this way getting him on the breast. As soon as she stopped
moving, baby fussed and cried and pulled off breast.>>
Two thought come to mind. Does this baby have food allergies? And was this
baby "high-need" from early on? Does he tend to require a lot of bouncing,
rocking vigourously, etc? I find that these babies often nurse poorly. I try
to find out if such behaviour might be birth trauma related. If it seems
likely (based on birth story, interventions, etc), then I try to get the mom
to use infant massage or a chiropractor well-trained in caring for bf babies
(in USA, usually a Network Chiropractor) or a cranial-sacral therapist. I
have seen such body work have magical results in traumatized infants. A need
for incessant vestibular stimulation is often my first clue that this is
warranted.
<<To increase supply, I’m trying to get her a better pump and to pump more
often (currently using one of those inverted nebulizer things only 4 or 5
times a day), trying to get prescription for domperidone. I’m puzzled
about the latching. It her case it won’t work to try alternative feeding
method other than bottles. Too many hassles with home situation, motivated as
she is. (They live in a tiny two-bedroom apartment, very sparse living
conditions). She will use the lactation aid, tho that didn’t seem to work
either in helping baby stay on.>>
I agree that the supplementer is unlikely to be effective at this point. I
would use another alternative feeding method, however.
<<What about taking a break from even offering the breast, so the baby can
“forget” the association with fussing at the breast? Or to keep trying? Or is
this hopeless nipple confusion? She can’t stand up every time she wants to
nurse him. I suggested lots of skin to skin, (not too practical with all
other kids around and ultra orthodox home; maybe only at night) attempting to
nurse while baby is sleepy (she has tried, appears not to help much), and to
stop trying as soon as baby fusses and cries. >>
I don't believe in hopeless nipple confusion. I do believe in regressive
therapy using a bath, as Chris suggested. I have first-hand experience of its
potential. I think someone suggested wearing the baby in a sling under her
top. I am working with a mother whose baby is addicted to a nipple shield. I
told her that she needs to become an opportunist. Rather than waiting for
"feeding times", she needs to avail herself of every opportunity to get her
baby to breast. This means keeping him touching her skin and at her breast
whenever possible. Good luck!
Jennifer Tow, IBCLC, CT, USA
***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html
|
