Did the OT who checked out this baby (10 month old who won't swallow
anything but abm) have training in sensory integration?  I have seen
severe feeding problems in kids with sensory integrative dysfunction.
One little boy would only breastfeed (very unhappily) for 3 to 5
minutes, 5 times a day.  He was gaining barely adequately, but mom was
concerned that he had to be coaxed to feed even when he was obviously
hungry.  She had weaned his older brother for the same issues, and had
even more difficulty with the bottle and solids.  I assisted the mom
with reading the baby's cues and helping him handle flow, and referred
her to an OT with Sensory Integration certification.  THe OT found
difficulties that could be treated, and he entered early intervention
therapy.  His older brother, who was "bad" at school, was subsequently
identified as having the same disorder, and is receiving help as well.
Mom bf the second baby for 10 months, and is still having difficulty
feeding him with solids and a cup.  She's very proud to have made it to
10 months.
        As for the psychosocial aspect of lactation "failure", I make it a
policy to review with the mom the challenges she faced with her
breastfeeding situation, and the resources she had- financial, temporal
(time), support, etc.  I praise her for the work she did and the length
of time she breastfed, and provide warm understanding of her need to
wean, while stressing how difficult this situation was.  This reframes
the situation from one of failure to one of running out of resources in
the face of a difficult obstacle.  3 months can be an eternity if every
feeding is a struggle.  If we are compassionate and praise the mom's
very real efforts, she can feel like a success even when she weans
before she had intended.  This 'reframing' is a cognitive therapy
technique.  How a mom feels about her attempt to breastfeed this baby is
important not only for her self-esteem, but for her ability to attempt
breastfeeding with her next baby, and her ability to support others who
are breastfeeding.  Feelings of failure are so unpleasant that some
people will not only never bf again, but will work hard at dissuading
all their loved ones from bfing.
--
Catherine Watson Genna, IBCLC  NYC  mailto:[log in to unmask]