Hi Sally,

My first thought in these sitiations is "what has changed or been different
in the last day or so?". Has there been any therapy that might cause oral
aversion? is the mother using a different underarm deodorant or is she on
different meds? No doubt you will find this out when you visit the mother
and her precious baby. I am concerned about the introduction of bottle use,
but I imagine the mother doesn't know how to set up tube-feeding for
(hopefully) short-term use.  Will she latvh with a well-fitted shgield?

Six weeks is the time when there have recently been all the 6-week
follow-ups, with paediatrician, obstetrician, and child health nurse
(health visitor?), ssometimes two appointments on the one day, and mothers
sometimes inadvertantly delay feeds while trying to fgind a parking spot,
and then wonder whether to feed in the waiting room or if they will be
called next. Consequently, the supply may have silently crept downwards.
So attention to increrasing the supply by taking out more milk gives the
baby a better flow - which may be just what she was waiting for, and didn't
respond without the good flow she previously experienced..

You are the clinician seeing this mother-baby dyad, and an experienced one,
and so you will pick up any other visual cues and sound cues that are there.

Best wishes,
Virginia

Dr Virginia Thorley, OAM, PhD, IBC:C, FILCA
Ipswich, Queensland, Australia

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