I saw an 8 day old yesterday for the first time, first time mother,
committed to breastfeeding but stressed. She had gestational
diabetes, they had planned to induce but water broke at 39 weeks and
baby was born, pitocin was used. Male infant was separated from
mother for at least a half an hour. He nursed with some difficulty
in the hospital. He had regained almost to his birth weight at 8
days. Infant was well hydrated and adequate output.
Mom had been given tons of conflicting and complicated advice. They
had been waking him every three hours, stripping him down and using a
cold washcloth to keep him awake, timing feeds and so on. Lots of
family visiting, wanting to hold baby and ignoring feeding cues and
making parents pretty frazzled. Maternal grandmother dropped in
twice during my 2 plus hour visit. The second time she recommended
the use of cow's milk and karo syrup.
Mom described hours of trying to latch, infant arching his back and
refusing the breast before suddenly latching and nursing. Mom had
bought an Evenflo pump and using once a day had developed sore nipples.
I encouraged them to let him wake on his own. So we waited for him
to wake on his own. We tried self latching, infant bobbed down to
breast, nice open mouth, licked nipple and then pulled away. He
didn't actively refuse the breast, but kept attaching and then not
latching. When mom expressed milk on the nipple, infant eagerly
licked at the nipple, but didn't latch. After a full hour of this,
he just latched on and nursed very well. It was like a switch turned
on and he knew what to do.
Mom said this is typical of most feeds, occasionally it will only
take ten minutes to latch, but mostly it takes up to two hours. This
has been further complicated by the fact that the infant doesn't
nurse ten minutes on each breast and so they spend further time
attempting to relatch.
We talked at length about not waking infant, watching for feeding
cues, signs of satiation, etc. I brought them a sling and showed
them how to use it.
I was there today, things had much improved, infant had slept 5 hours
last night, parents got some sleep, no one was crying and infant was
latching after ten or fifteen minutes. So I am encouraged, but not
sure what was going on with this very disorganized infant. Anyone
have any ideas?
Pat Thomas RN IBCLC
1335 Lakeview Avenue
Winona, MN 55987
1-507-458-8227
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