I saw an alert, happy, cooing 8 week old baby last night who has me stumped. Mom complained that since 3 weeks ago baby adamantly refuses the breast except when she is sleepy. Baby is screaming and arching and giving up meals. I had seen baby at one week old and observed what looked like good breastfeeding. Baby was getting satisfied and gaining weight ( This mother was staying in the facility where I work and ask me to take a look, just to be sure)
Last night, I saw a beautiful latch with much swallowing and all seemed fine. Mom was amazed, saying that she never eats like that. After a bit of talking she offered the baby the other side. Baby started to take a sip or two and broke into incredible scream turning almost purple and kicking and arching. The mother was gratified that at least I understood what she was talking about. After that could not get this baby relatched in any position. Calmed baby down and tried to have self attach from on top of mom. She was calm and poked around a bit but could not get a latch. Tried again in a more upright position on the other side- same kicking refusal. When I checked her suck she played around with her tongue, would create no suction, as if she had no idea what to do. Mom has tried: different positions, bottle feeding , having her SIL breastfeed her all meeting with the same violent reaction. No change in diet, meds, soap, detergent, perfume etc. There is no way to predict when this will happen. Sometimes she will start a meal and then pull away, sometimes she won't start though she is starving, and sometimes she will quietly nurse. Mom nursed previous 2 children 6-12 months. Calm and confident, though this baby is a real challenge. Was checked by pediatrician on the previous evening who found no problem. Baby does have a high and very narrow palate and unusual amount of white coating on her tongue. Tongue is flat when she cries, BUT until 3 weeks ago she was doing quite well –I couldn't blame her tt- it seemed too simplistic to me. Seems a bit low tone.
I suggested the following and told the mom I would keep thinking – ask for your help.
Bathe with baby, bf with lights off, CST, cup feed, anticipate and wake baby for feeds(ie feed in sleep)
Has anyone seen this kind of situation? ( I have had a couple of clients with breast refusal but it was just after birth or every feed or baby would at least take a bottle- she is not refusing the breast she is refusing to eat after a period of success.)
I would greatly appreciate your input!!
Thanks for listening , waiting for your wise words,
Riva Weissfish BA,CCE, IBCLC
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