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Date: | Mon, 9 Jan 2006 14:09:01 -0600 |
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I would do some test weights with supplementation at the breast (SNS or
periodontal syringe type device) and see if this increases baby's
intake. I have worked with a few moms that just by supplementing at the
breast we improve baby's ability to remove milk. After a few days, no
longer than a week, baby is cured. I have also worked with way too many
babies that could not remove enough milk by themselves at the breast.
They self limited and tired too quickly. We have a couple of excellent
OTs, and SLPs here in Houston that worked with these babies and got
their oral motor skills back to normal in about 8 weeks. With poor
weight gain, when mom can pump out more than baby can remove (verified
through test weights), then I look to poor oral motor skills. I also
watch the baby suck on a slow flow wide based bottle nipple to see where
they put their lips and how well they remove milk. If baby can't grip
with his lips on a wide based nipple, this makes me suspect weak lips.
And I sit baby upright on the bottle and see what they can or can not
do. Paced feeding can help a baby improve sucking ability. I would
encourage mom to do 2-3 days of pumping after every nursing to really
bump up her supply. And I would encourage her to use 3-5 capsules of
fenugreek taken 3 times a day (information from The Breastfeeding Answer
Book). Many IBCLCs recommend Blessed Thistle capsules to be taken with
the fenugreek in the same amounts. Because the test weights were so low,
I would suspect this was a baby issue initially. Poor sucking leading to
poor growth and poor milk supply.
Kathy Eng, BSW, IBCLC
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