Phew!  Glad to see the "HTML rich text" test I did earlier worked.  Now, on
with the post.

My name is Kathryn Ward.  I'm a LLL leader who has recently joined
Lactnet.  I have learned so much from all of you! I'm hoping you can offer
a fresh perspective for a mom I've been working with for about 6 weeks.
She is trying to get her baby back to the breast after a lengthy weaning. I
did search the archives, but need more input.  Here are the details (this
is a whopper):

-Baby is 8 1/2 mos., nursed for about 3 1/2 mos. successfully, then was
weaned for 3 1/2 mos. before starting the relactation process.

-Mom weaned for a tangle of reasons, one of which was a case of mastitis
and another was the baby being hospitalized with RSV.  In both instances
she was aware that weaning was not the best thing to do, but felt
overwhelmed, and that she had little family support to keep nursing.

-Mom's regrets intesified once the Christmas bustle had past, and the baby
started having problems with eczema.

-There are four children at home.  The baby, a toddler, a kindergartener,
and a 9 y.o.  She nursed the toddler and the kindergartner enjoyably and
without problem.  She is now feeling that her decision to wean the baby is
the root of his health problems.  Her other children have been very
healthy.  Of course, she also is mourning the loss of the nursing
relationship.

-She is producing some milk, but quit taking Reglan because it made her
feel weird and, she thinks, depressed.  I've given her info on domperidone
to share with her midwife (Thanks, Jack).

-She hates the SNS and finds pumping is time-consuming. She tried nipple
shields (her idea) for a brief time when the baby was biting due to
teething (teeth finally erupted this week).  We had also considered using
nipple shields with the SNS threaded through as a transition to the nipple
alone.

-She has successfully coached the baby from flat-out refusal of the breast
to taking the bottle against the breast skin-to-skin, and then taking the
breast a couple of times when he was sleepy.  We explored the possibility
of oral aversion from things that happened when he was hospitalized.  She
was clear on the need for gently offering rather that forcing.

-Other than the two times when he was sleepy, the baby just doesn't seem to
know what to do when the nipple is in his mouth (no wonder - bottle,
pacifier, nipple shield, weaned a good while back).  She said the suck
isn't a problem, but he's just bewildered, or chomps down (teething).

-I've referred her to another woman who relacted, directed her to
relactation websites, and provided other info I've found through LLL, etc.,
as well as offering LOTS of moral support and listening.  Guilt is a huge
factor.  She feels guilty for weaning, guilty for disrupting her family
life to relactate, and guilty for feeling she wants to give up.  I've
praised her for each little step, and reminded her that her initial intent
was to at least give it a good try, which she has done.  She has made so
much progress, and I feel she is actually very close to success.

-She has said she'd be happy if he got just a little milk, and could nurse
a couple of times a day.  She doesn't expect he will nurse fully.

-This weekend she is at the breaking point.  I've recommended a "nursing
honeymoon", and it seems she has it lined up.  However, I made the same
recommendation before, and she could not manage it.  The fact is that she
has 3 young kids and a baby at home, and helps at her husband's office part-
time.  She will have to be the one who makes the decision about what the
priorities are.

-I noticed when I met with her yesterday that her toddler never took the
pacifier out of his mouth.  She also kept offering a pacifier to the baby,
who spit it out.  He also was chomping on the side of her jaw, while
shaking his head back and forth "hungrily".  I offered that she could try
to nurse or even bring his bottle in to feed him, but she said she felt he
was just sleepy, not hungry.  Perhaps she just was uncomfortable in a
setting outside of home.  I called her later and suggested it may be
helpful to ditch the pacifier for the weekend, and explained again the
concept of looking at nursing not as a "food" issue but as a "comfort".  I
reitierated the need to carry the baby and "hang out" with him all day,
skin-to-skin when possible.  Also to offer the breast anytime he is the
least bit interested or she feels there might be a window of opportunity -
like when she sees the kinds of things he was doing yesterday.  (She said
she had read over and over that the pacifier needed to go, and just hadn't
had the heart to do it yet, but would try this weekend.)

Sorry this is such a hefty post, but it has been a long process.  I welcome
any additional insights you wise and wonderful folks may have.

Thanks!
Kathryn Ward, LLL
Shenandoah Valley, VA

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