I see babies weekly who in the first 72 hours bob and bob in
laid-back breastfeeding positions, without finding a breast. Some of
them have been born in water after unmedicated labors and never
separated from their mother's body, some of them have been delivered
by CS after failed ventouse and forceps. Almost no babies where I work
are suctioned at birth unless they get a 0 on the Apgar component for
reflexes and/or respiration. I am discouraged every time, especially
with the cases in the former group. Like, how DARE they not behave
according to the script? Most of the babies do start feeding normally
after several days but it is a trying time for the mothers and for the
staff, not to mention the babies.

Our protocol is to get mother hand-expressing colostrum which she then
feeds to baby by cup, spoon, or letting baby lick it off mother's
fingers. This is a situation when nipple shields often get used - and
honestly, I think that is better than sending a mother home expressing
and feeding the baby some other way, because the mothers seem to
prefer having the baby in their arms, suckling - and so do the babies.

I still don't know of any better way to handle them than to keep them
close to their mothers, preferably in laid-back breastfeeding
position, while we keep them fed and wait for whatever is keeping them
from feeding, to go away.

Of course I assess them for anatomical hindrances and the most common
one I find is tongue tie, no surprise there. But most of them have no
obvious factor that can explain their behavior.

Rachel Myr
Kristiansand, Norway

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