Hi,
  I made a house call last night to new parents (mom an RN) of a healthy
baby girl born late afternoon 8/22/96.  Mom frustrated because the nurses
didn't give her ANY bf help (when asked); there was the assumption that the
mom knew what to do because she was a nurse--she is not in OB or Peds.  The
hospital loaned her Medela's positioning video (special courtesy 'cause
she's a nurse), which she & hubby watched twice while trying to get things
going at home.
  Mom first called me early yesterday afternoon (after calling back to
hospital for bf help & someone gave her my name).  The ped (good w/ bf) had
told mom that baby would be ok without lots of food for 72 hr pp, but mom
was very uncomfortable with that info--baby was rooting like mad and sucking
fists, etc.  I think that ped's info was intended to be reassuring so
parents wouldn't get in a flap if baby didn't nurse well right away, but
they got worried anyway.  So they had given at least one abm bottle &
glucose water at home, & baby had a little of same in hospital.
  I could not see her until last night about 9 pm (taking our daughter to
college yesterday & got home at 8 pm).  The best I could do in the afternoon
was to tell her how to wake the baby (Nurses had said just wait for baby to
wake up & cry to let someone know she was hungry.  That's what had been done
in hosp. & mom got baby about every 4 hrs.) & to observe carefully for early
feeding cues.  Mom told me last night that baby woke up in the afternoon
10-15 min. after being uncovered, but did not suck longer than a few seconds
before crying.
  Anyhow, when I got to their home, the baby was awake and seemed ready to
nurse.  She rooted great, opened wide, went to breast quickly, and I
thought, "No problem".  WRONG!  That little gal pulled back, screamed bloody
murder, and things plunged downhill fast.  Finally got her to breast with a
starter SNS & abm.  Mom felt good latch & no pain.  Baby was happy and
nursing great as long as food was easily available.  Within seconds of
pinching the tube, she was off & screaming again.  We tried putting her to
the breast without the SNS in place, but she would not go one suck.  I was
going to slide the tubing into the edge of her mouth when I noticed she was
watching the SNS tubing out of the corner of her eye.  The next thing I
knew, she had let go of the breast, had her mouth open, & was headed
straight for the tube!  I drew back & she started screaming again.  I was so
stunned I started laughing.  Never have I seen a baby so clever and determined.
  We finally gave up on bf.  I worked with mom & G----- battery pump she had
bought; it never did work.  Mom said it hurt & we only got 1 drop of milk.
Funniest looking flange I've ever seen:  silicone with increasingly large
rings from pump to edge of flange.  I showed mom hand expression instead;
she did much better with that.  With much misgiving I finally had dad
finger-feed 1.5 oz abm because the baby really did seem hungry & parents
were dog-tired.  Showed them spoon feeding and asked them to consider doing
that as a means of feeding the baby if she was unglued & try bf again &
again & again...
  Told them to leave me a message today if they were desperate (more college
stuff for me), but heard nothing.  When I called them at 5 pm (didn't want
to know what I'd hear!), the mom was ecstatic.  The baby had suddenly given
in and bf twice (at least 10 min. each time) from 2-4:30 pm after the
seeming obligatory screaming.  Mom very happy & determined to carry on.
  This long, rambling account brings me to my questions for you.  Do you see
babies who get early bottles, yet have seemingly good feeding cues, scream &
pitch fits as this baby has done?  At what point in the continuum do you
feed the baby just to calm her down?  Do you find that there are some babies
who seem  strong-willed & incredibly stubborn about giving in and nursing at
this early age?  I've been an LC for 11 yrs. & LLLL for 10 yrs., and this
kind of situation leaves me feeling incredibly helpless.  Well, let's be
honest--a lot of situations leave me feeling helpless!  BF has so much
uncertainty for new parents (and for me).
  I just cannot account for what makes the difference & gets these babies to
turn the corner.  A lot of moms don't seem to have the intestinal fortitude
to stick it out and are quick to give bottles when the baby turns purple in
the face & screams herself hoarse, and who can blame them?  (Well, maybe I
do...at least a little bit.)
Thanks for "listening".  Sara Reuning in Bristol, TN, feeling a little
exposed & silly right now.  It's been a long weekend, and I miss my baby
(who's 18 and in college now).