Hi all,

Like others did, I wish you all a very happy 2009!

My working year started Friday morning with a consultation I cannot really come to grips with.
Although most of the situation looks fine, this is the problem: daughter of 3 weeks (40-weeker) does not sustain a strong suck long enough to take in a good amount of milk.
She dozes off, wakes up again, takes a few sips, falls asleep, wakes up, drinks a little while, closes her eyes, and so on.
Mother is a somehow desperate as to how she can hold on to a rhythm like this, when dad is back to work next Monday and she has to look after baby and daughter of three years old.
The note about the last weight check could not be found, so I'm not fully sure how much the baby gained in the last week or so (will suggest scale).
Anyway, I think the main issue is: how to encourage the little one to drink longer while at breast? Then she will probably also sleep a couple of hours regularly, allowing mom some sleeping time as well.
Mother pumps and gives the expressed milk in a bottle; would you prefer a tube at breast or another alternative feeding method?
Would perioral stimulation be a good idea to improve mouth strength? Baby seems to be close to mom, but slips off nevertheless. What to do about that?
I know I'm not complete in all the details, but my main question is about staying at breast, as all else seemed to be not that bad. Latch can do with some improvement, but does not seem to account for the short sucking bursts. Mom has enough milk and a good MER. Parents are keen on and pretty well informed about bf, but mom simply feels she cannot go on like this, without sleep and an endlessly drinking baby.
I would be very pleased to see some suggestions coming in while I'm asleep (going to bed now...). ;o)
Hope to get back to mom tomorrow and offer practical tips. Thanks for your input.

Warmly,

Marianne Vanderveen-Kolkena IBCLC
Borstvoedingscentrum Panta Rhei, Netherlands

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