I reiterate Barb Latterner's clarification question about the size of feeds
the baby is getting - is it 100 ml expressed milk PLUS 4 oz (approx 120 ml)
formula, or is it 4 oz total?  If the former, no wonder baby is non-rousable
more often than four hourly.

If half an hour of attempting to get a distressed baby to grasp the breast
and suckle does not work, I would change the strategy to ANYTHING that makes
the mother and baby happier to be in one another's company.  The bathing
suggestion is one good idea, but you can't do that at every feed.  I  might
suggest waking the baby up with a bit of milk, served in whatever way baby
seems to prefer, and then spending time skin to skin, or just front to
front, as described on www.biologicalnurturing.com, offering more milk as
needed to keep baby contented, while they try to replace unpleasant
experiences with pleasant ones.  

Pamela Morrison mentioned nipple shields and while they might work, I'd
strongly recommend trying simpler things first.  Sounds like this baby has
no positive experiences of becoming sated at the breast, and needs to be
given some reason to be there at all.  The principles I use when making a
plan in cases like this are 'feed the baby' and 'give the baby body
contact', both without any strings attached.  No 'you can lie in my arms if
you'll just LATCH' and no 'you can have food if you just try to LATCH long
enough'.  Mother should be prepared for her own emotional response if she
decides to try just letting the baby lie there and get to know her mother's
body. In my experience the mother gets really weepy because it's often the
first time she's just spent time being with, and loving, the baby rather
than feeling pressure to make the most of every second of contact to get the
baby to perform.  

She can also expect to be able to express more milk than she's used to
seeing, if she expresses after having the baby skin to skin for a good long
time first.

I'd expect it to take days, not hours, for this mother and baby to get on
the right track, but I would expect it to happen.  Good luck to them!

Rachel Myr
Kristiansand, Norway

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

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome