I gained a lot of confidence in working with older non-latching babies
(whether they've ever nursed or not), from working with a remarkable mother
recently.  Her baby, born 3 mo premature, had given up on the breast as a
source of anything positive when I first met them, a month after her due
date (about 4 months old).

For the first time ever, it really, really hit me that this is all just a
conditioning issue.  We can condition virtually any animal to do all sorts
of abnormal things.  Surely we can condition even the most adamantly
resistant baby to begin doing what he's built to do, if we make the steps
small enough.

For this couple, we began by having her play (bare-chested) with him on a My
Brest Friend pillow, chosen because it's so table-like.  She rolled him
toward her and away, teasing some part of him with her nipple at times but
not letting him do anything with it.  She added a nipple shield to this
routine, but the baby showed no interest in taking it into his mouth, which
is what we expected.

But then we did something really cool.  She started using a wide-based (for
Playtex-type bottles) Munchkin slow-flow teat.  (They've since been
discontinued, but Healthflow makes one that looks identical though I believe
the flow is faster.)  *We put a small-size nipple shield right over the
bottle teat* and the baby took all his meals that way from then on.

I'd always been frustrated that there was no easy way to feed a baby with a
nipple shield away from the breast.  The shield itself is very different in
shape from any bottle, and the jump from bottle to shield is plenty big
enough without throwing a breast into the mix.  But put a shield on your
thumb and the rim just crumples.  The baby can *mouth* it, but he can't
*use* it.

Well, it turns out it crumples only slightly on those hemispherical bottle
teats.  And the mom said its use didn't decrease his intake.

With bottle practice, he gradually accepted the shield more and more deeply
into his mouth, then accepted it at her breast when he was in the right
mood.  It took a bit longer for him to use it well enough to trigger a
let-down and discover that the shield worked for food at breast as well as
at bottle.  But from there it was a fairly short hop to exclusive
breastfeeding with the shield.

The tougher transition was to bare breast.  I haven't figured out how to
make that one a short hop, except to remember that babies generally seem to
take care of that themselves.  In this particular case, mom and baby were
having a tearful session at breast (he was still a difficult feeder who ate
only for food, not for comfort).  Dad suggested they try without the shield.
"We've done that a thousand times.  It never works," sighed Mom.  "Try it
one more time," said Dad.  And they've been exclusively bare-breastfeeding
ever since.

It took another month or two for all the feeding kinks (related both to
extreme prematurity and to a two-fold oversupply - I said she was a
remarkable mom) to work themselves out.  But they are now a breastfeeding
couple like any other.  And I don't think they'd have gotten there without
our silly little pillow games and the nipple shield on the bottle.  Very
cool!

This was all a strong reminder to me to think outside the box, and to think
of a baby's reluctance as a simple conditioning issue that just needs to be
addressed one small step at a time.
--
Diane Wiessinger, MS, IBCLC  Ithaca, NY
www.wiessinger.baka.com

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

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