I need some input on a baby I've been following (for free mind you).  The
baby is now 11 days old and sleepier than any other I've ever seen.  The
history goes as follows:  Mom with hypertension, told they would induce and
"spontaneously" went into labor (more like threatened into) at 37 weeks.
Mom received several intrathecal narcotics during labor and stadol.  Baby
boy, born vaginally, put to breast and reportedly latched on and nursed.
Baby never latched on sucessfully again.  Discharged early without nursing
well established.  Baby lost 15% of bw (6 lb 10 oz) in just 4 days (from
day 3 to 4 baby only had one wet diaper); diagnosed with "dehydration" by
MD and put on bottles (Playtex nurser) of EBM.  Mom seen 3 days post-part
by home health nurse who gave she shells for inverted nipples---EXCEPT THAT
THEY WERE ACTUALLY THE SHELLS FOR SORE NIPPPLES--and nipple shields (which
mom fortunately wasn't comfortable wearing while nursing).  Baby also
diagnosed with "slight jaundice" (also causing sleepiness).  Mom had been
pumping and giving bottles and managed to get the weight up to 6 lbs by 11
days (and 6-8 wet diapers).  I spoke with her at 8 days and figured out the
shells were the wrong ones--had husband pick up the right ones (I had been
out 3 nights till 10 and couldn't do another visit at 10:30PM).
        Next day, I saw baby--completely over-dressed (2 terry sleepers, a
onesie and cloth diaper with cover) and extremely floppy (esp. head and
arms) with that classic charpee puppy look).  Tried all the usual to get
baby to latch...no luck, just layed at breast. Tried dripping milk onto
breast (somewhat engorged) to entice him--no response, no licking.
Undressed, wash-clothed him, tickled, etc...did suck assessment (unremark.
except tongue thrust dues to nipple confusion).  When I finally awakened
him, I was able to cup feed 1.5 oz and get his tongue down and out over
lower lip.  Mom and dad unable to master cup feeding without becoming too
frustrated.  I then went to Haberman with some initial resistance on baby's
part, but then success.  Baby very willing to take full nipple of Haberman
(full size) into mouth and compress.  After 3 oz, baby then latched onto
mom (nipples still flat in spite of pumping and shells) and actively nursed
for 20 min.
        Next day, mom overwhelmed by relatives staying in their 500 sq ft
family student housing apartment.  I called to encourage.  Morning after
that (today), re-visited and found mom not giving enough of Haberman into
mouth.  Could not awaken baby long enough to get him latched.  Discussed
infant stim, demonstrated baby massage, tried more positions (including
leaning over him), and not having much success with latch.  Baby has
demonstrated that he is able to be re-trained and able to compress
Haberman.  Mom is now exhausted from pumping and feeling rejected.
Suggestions would be most appreciated.  TIA!
Chris

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Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC email: [log in to unmask]
   HSR & Educational Consultant         fax:   541 753 7340
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               **CHANGE THE WORLD, NURTURE A CHILD!**
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